Management Protocols for Acute Maxillofacial Infections in Resource-Limited Settings: A Clinical Audit at Benue State University Teaching Hospital

Acute maxillofacial infections, including fascial space abscesses and deep neck space infections of odontogenic origin, require prompt and decisive clinical management to prevent life-threatening complications. In resource-limited tertiary institutions, adherence to evidence-based management protocols may be compromised by shortage of surgical supplies, laboratory delays, and variable clinical experience among residents. This clinical audit evaluates the management of acute maxillofacial infections against a defined standard of care at Benue State University Teaching Hospital (BSUTH), Makurdi, North Central Nigeria. Clinical records of 68 acute infection cases managed between 2021 and 2023 were audited against pre-defined criteria derived from current international guidelines. Criteria assessed include time to incision and drainage, microbiological specimen collection, antibiotic selection appropriateness, fluid management, daily wound irrigation, airway monitoring, and post-treatment follow-up scheduling. Results indicate that while time to incision and drainage met the standard in 78% of cases, microbiological culture was performed in only 22% of presentations, primarily due to absence of a functional microbiology service. Antibiotic selection was inappropriate in 31% of cases based on published pharmacological guidelines. The audit concludes with a structured re-audit plan incorporating improvements to laboratory access, antibiotic prescribing checklists, and structured infection management ward rounds. Keywords: maxillofacial infections, clinical audit, management protocols, Makurdi, North Central Nigeria.