should you give prophylactic antibiotics for intraoral wounds?

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