Does the use of amoxicillin/amoxicillin–clavulanic acid in third molar surgery reduce the risk of postoperative infection? A systematic review with meta-analysis

Menon, Rohit Kunnath; Gopinath, Divya; Li, K.Y.; Leung, Yiu Yan; Botelho, MG

doi:10.1016/j.ijom.2018.08.002

Cited by 45 publications

(55 citation statements)

References 58 publications

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“…The preference for amoxicillin in the current study reflects the worldwide affinity for this antibiotic among practitioners for preventing postoperative infections after third molar extractions . A recent systematic review reported a reduction in the risk of postoperative infection with the use of amoxicillin‐clavulanic acid combination . However, that review concluded that the use of amoxicillin alone does not significantly reduce the risk for postoperative infection, which suggests that the current preference on the solo use of amoxicillin is not generated based on solid evidence.…”

Section: Discussionmentioning

confidence: 91%

“…Thus, early diagnosis and the management of such postoperative infections should be prioritized over widespread antibiotic prescription to prevent a possible outcome of infections which, as discussed earlier, are quite minimal, as depicted in our study, as well as other studies. In addition, framing policies for the judicious use of the antibiotics by restricting them to those at high risk of infection is concurrently recommended …”

Section: Discussionmentioning

confidence: 99%

“…In addition, framing policies for the judicious use of the antibiotics by restricting them to those at high risk of infection is concurrently recommended. 50 The inherent bias associated with incomplete and inaccurate reporting from case records is a limitation of the current study.…”

Section: Antibiotic Prescription To Prevent Postoperative Infectionmentioning

confidence: 93%

“…[44][45][46][47][48][49] A recent systematic review reported a reduction in the risk of postoperative infection with the use of amoxicillin-clavulanic acid combination. 50 However, that review concluded that the use of amoxicillin alone does not significantly reduce the risk for postoperative infection, which suggests that the current preference on the solo use of amoxicillin is not generated based on solid evidence. In the current study, patients who had two teeth extracted were as depicted in our study, as well as other studies.…”

Section: Antibiotic Prescription To Prevent Postoperative Infectionmentioning

confidence: 99%

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Is there a need for postoperative antibiotics after third molar surgery? A 5‐year retrospective study

Menon

Botelho

2019

J of Invest & Clin Dent

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Aim Randomized controlled trials might be reporting a higher postoperative infection rate for third molar surgery compared to other study designs due to unclear criteria for the classification of “infections”. The aim of the present retrospective study was to assess the infection rate after third molar surgery with and without postoperative antibiotic prescription. Methods Case records of patients who underwent third molar extractions at the Prince Philip Dental Hospital in Hong Kong between 3 July 2012 and 22 June 2017 were evaluated retrospectively. Data extraction was performed for indications, clinical and radiographic findings, antibiotic treatment, postoperative complications, and treatment for postoperative infection. The odds ratio (OR) for postoperative infection was estimated. Results In total, 1615 extracted over 5 years from 992 patient records were included in the final analysis. Antibiotics were prescribed postoperatively for 44% of the extractions. The overall infection rate was 2.05%. There was no significant difference in infection rates between the groups which underwent extractions with or without antibiotics (OR = .68; P = .289). We found a significantly higher risk for infections with increasing age (P = .002). Conclusion Infection rates after third molar extraction is minimal in the current setting, with no significant benefit from postoperative antibiotic prescription.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Antibiotic Prescription To Prevent Postoperative Infectionmentioning

confidence: 93%

Section: Antibiotic Prescription To Prevent Postoperative Infectionmentioning

confidence: 99%

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Is there a need for postoperative antibiotics after third molar surgery? A 5‐year retrospective study

Menon

Botelho

2019

J of Invest & Clin Dent

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“…Unfortunately, during the past few decades, an increasing number of bacterial species have become resistant to AMX, making ABR one of the most critical health problems in the world . Lately, it was suggested that dental care professionals should avoid administering AMX to prevent ABR, especially in procedures in healthy patients during third molar surgery …”

Section: Antibiotic Prophylaxis Guidelines Recommended By Aha For Bacmentioning

confidence: 99%

Prevention of infective endocarditis and bacterial resistance to antibiotics: A brief review

Loyola-Rodríguez

Miranda

Loyola-Leyva

et al. 2019

Special Care in Dentistry

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The purpose of this statement is to debate the recommendations of the American Heart Association (AHA) for the prevention of infective endocarditis through an antibiotic prophylaxis protocol and its relation with bacterial resistance to antibiotics. Since dental infections involve biofilms that include several bacterial species (Gram‐negative and Gram‐positive), it is essential, from the dental point of view, to consider the frequency, magnitude, and duration of bacteremia associated with active dental infections before applying antibiotic prophylaxis. The actual guidelines for antibiotic prophylaxis should be revised according to recent evidence of bacterial resistance. Amoxicillin/clavulanic acid and moxifloxacin should be considered due to their effectiveness against bacteria associated with oral, GU, and GI infections and the low rates of antibiotic resistance associated with these antibiotics, instead of the actual protocol, which includes amoxicillin (2 g) or clindamycin (600 mg) administered an hour before the dental procedures. The breaking point to test the antibiotic bacterial resistance (ABR) had a wide range in the different studies that were analyzed, which could explain the widely varied ABR percentages reported for the various antibiotics used for antibiotic prophylaxis.

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Antibiotics to prevent complications following tooth extractions

Lodi

Azzi

Varoni

et al. 2021

Cochrane Database of Systematic Reviews

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Does the use of amoxicillin/amoxicillin–clavulanic acid in third molar surgery reduce the risk of postoperative infection? A systematic review with meta-analysis

Cited by 45 publications

References 58 publications

Is there a need for postoperative antibiotics after third molar surgery? A 5‐year retrospective study

Is there a need for postoperative antibiotics after third molar surgery? A 5‐year retrospective study

Prevention of infective endocarditis and bacterial resistance to antibiotics: A brief review

Antibiotics to prevent complications following tooth extractions

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