From the Guidelines
Antibiotics are generally recommended for maxillary sinus fractures to prevent infection, especially if there is a concern for contamination or exposure of the sinus cavity 1.
Common Antibiotic Choices
- A common choice is amoxicillin 500 mg TID for 7 days 1
- Alternatively, in patients with penicillin allergy, clindamycin 300 mg TID for 10 days can be used 1
Important Considerations
- The decision to use antibiotics should be individualized based on the patient's specific condition, fracture severity, and clinical judgment 1
- In cases of postoperative infection, a combination of amoxicillin/clavulanic acid and metronidazole or levofloxacin may be used for 7-10 days 1
- If symptoms persist beyond 3 weeks, a surgical approach with partial or total removal of the bone graft may be necessary 1
From the Research
Antibiotic Use in Maxillary Sinus Fractures
- The use of antibiotics in maxillary sinus fractures is a topic of debate, with some studies suggesting that they may not be necessary in all cases 2, 3.
- A study published in 2016 found that there was no difference in the outcome of patients receiving short-term, long-term, and no antibiotic prophylaxis for nonoperative facial fractures, including maxillary sinus fractures 2.
- Another study published in 2015 found that a 3-day course of antibiotics was not effective in preventing acute sinusitis after maxillary sinus fractures 3.
- However, a more recent study published in 2023 found that a single perioperative dose of antibiotics was effective in minimizing postoperative complications following open reduction and internal fixation of maxillofacial fractures, including maxillary sinus fractures 4.
Specific Antibiotic Regimens
- A study published in 1983 recommended penicillin V as the first antibiotic drug of choice for treating maxillary sinusitis, with cefaclor, tetracyclines, or trimethoprim recommended in patients allergic to penicillins 5.
- A systematic review published in 2003 found that penicillin or amoxicillin for 7 to 14 days was effective in treating acute maxillary sinusitis confirmed radiographically or by aspiration 6.
Conclusion is not allowed, so the response will continue with more information
Complications and Side Effects
- The use of antibiotics can be associated with complications and side effects, such as Clostridium difficile colitis 2 and adverse effects leading to dropouts 6.
- A study published in 2023 found that increased numbers of complications were noted in patients treated with an intra-oral approach, regardless of the antibiotic regimen used 4.