Effect of antibiotic prophylaxis for preventing infectious complications following impacted mandibular third molar surgery. A randomized controlled trial

Nicolás Yanine; Nicole Sabelle; Valentina Vergara-Gárate; Josefina Salazar; Ignacio Araya; Alonso Carrasco-Labra; Conchita Martín; Julio Villanueva

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Effect of antibiotic prophylaxis for preventing infectious complications following impacted mandibular third molar surgery. A randomized controlled trial

Nicolás Yanine ^[1] ; Nicole Sabelle ^[1] ; Valentina Vergara-Gárate ^[1] ; Josefina Salazar ^[1] ; Ignacio Araya-Cabello ^[1] ; Alonso Carrasco-Labra ^[3] ; Conchita Martin ^[2] ; Julio Villanueva ^[1]
1. [1] Universidad de Chile
  
  Universidad de Chile
  
  Santiago, Chile
2. [2] Universidad Complutense de Madrid
  
  Universidad Complutense de Madrid
  
  Madrid, España
3. [3] Department of Evidence Synthesis and Translation Research, Science and Research Institute, American Dental Association, Chicago, IL, USA; Department of Oral and Craniofacial Health Science, School of Dentistry, University of North Carolina at Chapel Hill, NC, USA
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Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 26, Nº. 6 (November), 2021
Idioma: inglés
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Resumen
- The objective of this study was to determine the effect of antibiotic prophylaxis in preventing postoperative infections after extraction of impacted mandibular third molars.
  
  A Parallel-group, randomized, blind, placebo-controlled trial was performed. 154 patients were randomly allocated to 2 groups; experimental (n=77) receiving 2g amoxicillin 1 hour prior to surgery and control (n=77) receiving placebo. Primary outcome was postoperative infections and secondary outcome was the need for rescue analgesia.
  
  4.5% of patients developed postoperative infections, five patients of the control group (4 alveolar osteitis, 1 surgical site infection) and two of the experimental group (1 alveolar osteitis, 1 surgical site infection). Difference between groups was not statistically significant, RR=0.4 (95%CI 0.08-1.99, 𝘱=0.41) NNTB=26. Rescue analgesia intake was significantly higher in the control group (41 vs 18 patients of experimental group) RR=0.49 (95%CI 0.32-0.75, 𝘱<0.05) NNTB=3.
  
  The use of 2g amoxicillin 1 hour before surgery was not effective in significantly reducing the risk of postoperative infections from impacted mandibular third molars extraction, when compared to placebo. Nevertheless, antibiotic prophylaxis was associated with a reduced need for rescue analgesia.