Antibiotics, overuse and prevention

Abstract

Anti-microbial prophylaxis in oral and maxillofacial surgery procedure rules out the anticipation of the contamination of the careful injury, either because of the qualities of the medical procedure or the general condition of the patient. This hazard increments with the sullying of the careful activity zone, making it important to suggest a prophylactic treatment of the disease in clean-polluted and tainted medical procedures and treatment of the contamination in filthy surgeries. Moreover, a legitimate careful strategy decreases the advancement of the postsurgical contamination. The elective anti-infection therapy ranges from penicillin-derivates with beta lactamase inhibitors (amoxycillin-clavulanate, ampicillin -sulbactam) to second or third era cephalosporins, quinolones or clindamycin. The sign for the utilization of these anti-infection agents relies upon the kind of medical procedure in oral and maxillofacial medical procedure, as per the level of tainting. Thus in oral surgery and surgery of the salivary glands the literature demonstrates that there is not a better prognosis when using prophylactic antibiotherapy instead of not using it in healthy patients. In traumatology this prophylaxis is justified in compound fractures and those communicating with paranasal sinuses. In orthognathic surgery there is disagreement according to the criteria of using antibiotic prophylaxis, but short term treatment is preferred in case of using it. In oncological surgery it has been demonstrated the reduce in incidence of postsurgical infection using prophylactic preoperative antibiotherapy, mostly in those cases in which oral mucosa and cervical area contact.