[Comparative study of clinical effectiveness of antibiotic prophylaxis in aseptic mouth-jaw- and facial surgery]. / Vergleichende Studie zur klinischen Effizienz der Antibiotikaprophylaxe in der aseptischen Mund-, Kiefer- und Gesichtschirurgie.

METHODS: This study evaluates the clinical efficiency of four regimens of antibiotic prophylaxis against wound infection in aseptic oral and maxillofacial surgery that does not involve implantation of foreign material and included 140 adult patients randomly distributed into four groups. Patients from two groups received prophylactic amoxicillin/clavulanate in a single-dose regimen or a 5-day regimen, respectively. Subjects from the other two groups received cefazolin in a single-dose regimen or a 5-day regimen, respectively. RESULTS: Clinical prophylactic efficiency proved to be equal for the four types of antibiotic regimens. DISCUSSION: Single-dose regimens are more economical, easier to administer, and carry a lower risk of inducing bacterial resistance. Amoxicillin/clavulanate is more expensive than cefazolin. For aseptic maxillofacial surgery that does not involve implantation of foreign material, we recommend preoperative single-dose antibiotic prophylaxis with cefazolin 2 g i.v. (in adult patients).

Oral transmucosal ketamine: an effective premedication in children.

The oral cavity offers a simple, painless way of drug administration. For this reason, we used oral transmucosal ketamine (5-6 mg.kg-1) for premedication in 25 children and compared it with intranasal ketamine (5-6 mg.kg-1), placebo and intramuscular ketamine (5-6 mg.kg-1). Oral transmucosal ketamine (OTK) provided effective sedation, facilitated i.v. line insertion and was accepted with pleasure by the patients (as lollipops). The lollipops produced a slight increase in gastric volumes but did not affect gastric pH. In conclusion OTK has been shown to be an effective, harmless preoperative medication in paediatric patients.