Antibiotic prophylaxis for mandibular advancement with bilateral sagittal split osteotomy: a comparison of three versus four doses penicillin V

Aim Compare two regimens of antibiotic prophylaxis on the development of surgical site infection (SSI) following mandibular advancement with bilateral sagittal split osteotomy (BSSO). Materials and methods In total, 176 patients were included. Two antibiotic regimens were administered intravenously. The first 114 patients were given penicillin V (PcV) in three doses every 8 h (PcV3‐group), and the next 62 patients were given PcV in four doses every 6 h (PcV4‐group). The same surgical protocol was followed for all patients. Development of SSI was registered at follow‐up 2 months and 1 year after surgery. Results A significant reduction in the rate of SSI was found in the PcV4 group compared to the PcV3‐group (P = 0.012). The infection rates were 4.8% and 19.3% respectively. A higher prevalence of SSI was found when mandibular wisdom teeth were present, but this was not statistically significant. There were no correlations between gender, age, intraoperative bleeding and operation time and the development of SSI. None of the patients developed severe infection. Conclusion The infection rate was significantly reduced when PcV was administered in four doses, suggesting that an extended regimen of antibiotic prophylaxis is beneficial when performing mandibular advancement with BSSO.