Effect of phenoxymethylpenicillin and erythromycin prophylaxis on anaerobic bacteraemia after oral surgery

Abstract

The effect of antibiotic prophylaxis on bacteraemia was assessed in 60 oral surgery operations. Fifty-one patients were divided in three groups receiving a 2 g dose of phenoxymethylpenicillin, a 0.5 g dose of erythromycin or no prophylaxis. During operation, the total numbers of bacteria were lower in the antibiotic groups than in the non-treatment groups (P less than 0.05). The number of patients with anaerobic bacteraemias, however, were similar in all three groups. The incidences of bacteraemia 10 min after operation were significantly lower in the antibiotic groups (P less than 0.05). The minimum inhibitory concentrations (MICs) of phenoxymethylpenicillin were below 2 mg/l in 93% of the strains and the minimum bactericidal concentrations (MBCs) were below this value in 80% of the strains. The MICs of erythromycin were below 2 mg/l in 80% of the isolates, and the MBCs were between 4-32 mg/l in 62% of the isolates.

Prevalence of bacteraemia following third molar surgery

“…In contrast, Takai et al (2005) found similar percentages of positive postextraction blood cultures between patients treated under general anaesthesia and those treated using local anaesthesia (57.7% and 58.1% respectively). The prevalence of B‐TME detected in the present series was similar to that reported in previous studies performed under local anaesthesia (Josefsson et al , 1985; Heimdahl et al , 1990).…”

“…In contrast, although the influence of the number of third molars extracted on the prevalence of B-TME at 15 min was not analysed in our series (because all but two patients underwent three to four third molar extractions), the duration of the surgical intervention was similar in the patients with positive blood cultures at 15 min and in those with negative blood cultures. This result is in agreement with the findings of Josefsson et al (1985) who studied the influence of surgical time on the prevalence of B-TME, detecting no correlation between the two variables.…”

“…Probably influenced by this premise, the prevalence of B-TME has been only determined for up to 10-15 min after ending the surgical procedure in the majority of the studies. In the present series, we found positive blood cultures at 15 min in a higher percentage of patients than in previous series (25-40%) (Josefsson et al, 1985;Heimdahl et al, 1990;Rajasuo et al, 2004b). However, in those studies the persistence of B-TME (at 10-15 min) was evaluated after a single third molar extraction while in our series it was analysed after completing three to four third molar extractions (in all but two patients).…”

Comparative Efficacies of Amoxicillin, Clindamycin, and Moxifloxacin in Prevention of Bacteremia following Dental Extractions

“…The power of the study was calculated by comparing the "prevalence of bacteremia" obtained at 30 s after the dental extractions between a preliminary control group (n ϭ 14) and a preliminary AMX group (n ϭ 12), CLI group (n ϭ 15), and MXF group (n ϭ 12). The prevalence of bacteremia in this control group was 93%, that in the AMX group was 58% (statistical power, 0.6; estimated sample size, 21), that in the CLI group was 87% (statistical power, 0.08; estimated sample size, 392), and that in the MXF group was 42% (statistical power, 0.8; estimated sample size, 11).…”

Dental Disease and Periprosthetic Joint Infection

“…Oral clindamycin was found to decrease the risk of bacteremia by 15%, from 88% to 74.9% 36,[39][40][41] . Although oral penicillin has been reported to decrease the risk of bacteremia by just 32%, from 66.7% to 45.1% 31,33,42,43 , intravenous or intramuscular penicillin decreased the risk of bacteremia by 68%, from 56.7% to 18% [42][43][44][45] . To our knowledge, neither oral cephradine nor cephalexin has been studied in randomized controlled trials for the prevention of bacteremia with dental procedures.…”