should you give prophylactic antibiotics for intraoral wounds?

23 Mar
GOOD QUESTION:

–(anecdotally) many intraoral lacerations seem to be people biting themselves or somehow teeth-related
–do we need to treat these like other bite wounds? (e.g. with antibiotics)

THE DATA (sort of):
limited studies with small numbers

no statistically significant differences in the incidence of infection with systemic oral antibiotics vs placebo.

trends indicate a decrease in the rate of infection if patients comply with antibiotic regimens

–a report showing no infection in 28 children who did not receive antibiotics

–suggestions include prescribing antibiotics for dirtier wounds, through & through lacs, and bite-related wounds

BOTTOM LINE:
–data is inconclusive (awesome)
use your clinical judgment (wasn’t this helpful?)
–deeper, dirtier, delayed presentation, etc—common themes for recommending antibiotics
–augmentin or clindamycin are decent choices, if antibiosing

Submitted by S. Lee.

Reference(s): annals review; trauma review; uptodate.com: evaluation and repair of tongue lacerations; picture

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