48-Hour versus 7-day antibiotic prophylaxis in the prevention of surgical site infection after simple dental extractions: A randomised clinical trial with amoxicillin

Abstract

ObjectiveThe aim of this study was to evaluate the efficacy of 48-h antibiotic prophylaxis in the prevention of surgical site infections during simple dental extractions by conducting a clinical trial controlled by 7-day antibiotic therapy. Our hypothesis was that there was no difference between these two protocols in the prevention of surgical site infection. Methodology: This was a 6-month randomised multicentre clinical trial conducted in three health facilities in the city of Yaoundé. The study included any patient aged 18 years or older who was scheduled for a simple dental extraction. The calculated sample size was 142 patients randomly divided into 2 groups. Group I consisted of patients who took 1 g of amoxicillin 1 h before surgery and then 1 g every 12 h for 48 h. Group 2 took amoxicillin only postoperatively at a rate of 1 g every 12 h for 7 days. The control was done at day and day 7. The primary endpoint was the occurrence of surgical site infection and the secondary endpoints were the occurrence of dry socket, oedema and pain. ResultsNo statistically significant difference was found at the 5% level between the two protocols regarding the occurrence of pain, postoperative oedema and surgical site infection with respective p-values of 0.834; 0.414; 0.175. In addition, a statistically significant difference was found for dry socket disease (p-value = 0.0149) showing a reduced risk in the 48-h group. ConclusionIt was found that there was no difference between these two protocols except for dry socket disease where the 48 h antibiotic prophylaxis protocol seems to be more effective. Furthermore, the question of the necessity of antibiotic prophylaxis for simple extractions remains, as only a randomised placebo-controlled clinical trial could provide answers.