Vol.67 No.3 May 2019
Retrospective analysis of the efficacy of antimicrobial prophylaxis for surgical removal of impacted mandibular third molars
Department of Oral and Maxillofacial Surgery, National Defense Medical College Hospital, 3-2 Namiki, Tokorozawa, Saitama, Japan
Abstract
Surgical removal of impacted mandibular third molars is one of the most common operations in the field of oral and maxillofacial surgery. In Japan, there are very few reports on antimicrobial prophylaxis for surgical removal of impacted mandibular third molars. We conducted a retrospective analysis to evaluate the influence of antimicrobial prophylaxis including the timing of its administration on the incidence of surgical site infection (SSI) in subjects undergoing removal of an impacted mandibular third molar.
Our study comprised 364 cases; 358 had received amoxicillin (AMPC), and 6 had received azithromycin (AZM). The overall SSI rate was 2.7% (10/364). The SSI rate was higher in patients who had received a single preoperative dose of AMPC 250 mg than in those who had received a preoperative dose of AMPC 250 mg plus AMPC 750 mg on postoperative day (POD) 1 (9.5% (4/42) vs. 2.0% (6/305); p=0.023). There were no cases of SSI in the following 3 groups; groups that had received one preoperative dose of AMPC 250 mg plus AMPC 1,000 mg on POD 1 (0/1), one preoperative dose of AMPC 250 mg plus AMPC 750 mg on each of POD 1 and 2 (0/10), and one preoperative dose of AZM 2 g (0/6). No statistically significant differences in the gender, age, type of impactions or frequency of surgery with ostectomy were found between the SSI group and no-SSI group.
Our study results suggest that prophylaxis with one preoperative dose of AMPC 250 mg plus AMPC 750 mg on POD 1 represents adequate antimicrobial prophylaxis for surgical removal of impacted mandibular third molars.
Key word
antimicrobial prophylaxis, mandibular third molar, surgical removal
Received
September 10, 2018
Accepted
December 25, 2018
Jpn. J. Chemother. 67 (3): 385-391, 2019
