Abstract
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.
Highlights
Surgical extraction of impacted mandibular third molar is one of the most commonly performed procedures in oral and maxillofacial surgery.[1,2,3] The procedure is classified as “cleancontaminated” group of surgeries.[4]
A total of 120 pieces of paper corresponding to each member of sample population were taken; on half of these papers (60) Amoxicillin were written and on the other half (60) Azithromycin were written in order to create two sample groups: Group A and Group B
Cases were randomized into two groups: Group A patients were prescribed with post-operative dose of 500 mg Amoxicillin three times a day for five days and Group B patients were prescribed with postoperative dose of 500 mg Azithromycin once a day for three days
Summary
Surgical extraction of impacted mandibular third molar is one of the most commonly performed procedures in oral and maxillofacial surgery.[1,2,3] The procedure is classified as “cleancontaminated” group of surgeries.[4] Pain, trismus, swelling and infection are the common significant post-operative complications associated to it.[1,2,5] These complications affect the patients quality of life in the first few days postoperatively.[4] Their incidence have been documented to range from 2.3% to 88.9% for pain, 5.7% to 14.3% for trismus and 1.3% to 12.0% for swelling.[6,7] risk of infection has been reported to range from 1-12.6%.8,9. Antimicrobials are usually prescribed to minimize these complications. Amoxicillin is one of the most commonly and widely prescribed antimicrobial for this purpose.[2]
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