Amoxicillin is the commonly prescribed antimicrobial for prevention of post-operative complications following surgical extraction of mandibular third molar. However recently, the use of macrolideantibiotics had been encouraged in dentistry. The aim of this study was to compare the efficacy of Amoxicillin and Azithromycin in preventing post-operative sequelae following third molar surgery. An open- labeled randomized controlled study was carried out in Department of Oraland Maxillofacial surgery, college of Dental Sciences and Hospital, Nepal Medical College (CODSHNMC), Attarkhel, Kathmandu, Nepal from May 2018 to June 2019. One hundred and twenty patients undergoing surgical extraction of impacted mandibular third molar were randomized by lottery method into two groups: Group A received Amoxicillin and Group B received Azithromycin. Both the groups were assessed postoperatively on 1st, 3rd and 7th days for post-operative complications- pain, swelling, trismus and pus discharge. The present study revealed no significant differences between the efficacy of Amoxicillin and Azithromycin in preventing postoperative sequelae following surgical extraction of impacted third molar. Amoxicillin and Azithromycin were therefore found to be equally effective. Thus, Azithromycin can be used as an alternative drug to Amoxicillin in case of resistance and intolerance to Amoxicillin.

Background: Self-medication of antibiotics is common among healthcare students due to their knowledge of pharmacology of antibiotics, which produces a false sense of confidence in self-diagnosis of disease conditions. Hence, this study was conducted to assess the practice of self-medication with antibiotics among medical students.Methods: This questionnaire based descriptive, cross-sectional study was conducted in Nepal Medical College Teaching Hospital, Attarkhel, Kathmandu from September 2019 to February 2020 on the Bachelor of Medicine and Bachelor of Surgery students.Results: Out of 405 students, 214 (52.8%) students had practiced antibiotics self-medication. The most commonly self-medicated antibiotics were azithromycin 126(58.9%), amoxicillin 67(31.3%), metronidazole 35(16.4%) and ciprofloxacin 14(6.5%) that were most commonly used for sore throat 93(43.5%), fever 82(38.3%), common cold 59(27.6%) and cough 43(20.1%).The common sources for self-medication were previous prescription 66 (30.8%), followed by own pharmacological knowledge 58 (27.1%). The most common reasons for practicing antibiotics self-medication were stated as previous experience of same illness 165 (77.1%), doctor’s advice not deemed necessary 21 (9.8%) and save time 14 (6.6%). Large number of students agreed that antibiotics self-medication was not an acceptable practice 308(76.1%) and can lead to antimicrobial resistance 363(89.6%). Conclusions: More than half of the respondent medical students had practiced antibiotics self-medication. Sore throat was the commonest cause for it while the most commonly self-medicated antibiotic was azithromycin. Self-medication with antibiotics in medical students is concerning because they are future prescribers of antibiotics; who are supposed to promote rational use of antibiotics.Keywords: Antibiotics; antimicrobial resistance; awareness; medial students; self-medication