Effect of antibiotic prophylaxis for preventing infectious complications following impacted mandibular third molar surgery. A randomized controlled trial / Efecto de la profilaxis antibiótica para prevenir complicaciones infecciosas después Cirugía de tercer molar mandibular impactado. Un ensayo controlado aleatorio

ABSTRACT

Background: The objective of this study was to determine the effect of antibiotic prophylaxis in preventing post-operative infections after extraction of impacted mandibular third molars.Material and Methods: A Parallel-group, randomized, blind, placebo-controlled trial was performed. 154 patientswere randomly allocated to 2 groups; experimental (n=77) receiving 2g amoxicillin 1 hour prior to surgery andcontrol (n=77) receiving placebo. Primary outcome was postoperative infections and secondary outcome was theneed for rescue analgesia.Results: 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). Dif-ference between groups was not statistically significant, RR=0.4 (95%CI 0.08-1.99,p=0.41) NNTB=26. Rescueanalgesia 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.Conclusions: The use of 2g amoxicillin 1 hour before surgery was not effective in significantly reducing the risk ofpostoperative infections from impacted mandibular third molars extraction, when compared to placebo. Neverthe-less, antibiotic prophylaxis was associated with a reduced need for rescue analgesia.(AU)