Efficacy of Single Dose Azithromycin as Prophylactic Antibiotic in Surgical Removal of Mandibular Third Molars: A Clinical Study

Abstract

To evaluate the efficacy of single dose Azithromycin as prophylactic antibiotic in surgical removal of mandibular third molar. The study was carried out as an open clinical trial on fifty (23 males & 27 females) patients chosen from the ones referred to our Oral & Maxillofacial Surgery Department for surgical removal of mandibular third molar (SRMTM). Pre-surgical evaluation of pain, swelling, lymphadenopathy, fever and purulent discharge from the surgical site were made. All patients were administered oral Azithromycin 500mg, 1 hour prior to the procedure. The patients were followed up clinically for a minimum period of 10 days post operatively. Evaluation for pyrexia, purulent discharge from surgical site, persistent pain &/or swelling & lymphadenopathy was done on 1st, 3rd, 7th and 10th postoperative day to determine SSI (surgical site infection). All patients received same set of post-operative medications (Tab. Diclofenac sodium (50mg) TID, Tab. Ranitidine 150 mg BID for 5 days) and set of instructions. Surgical site infection was seen in only one patient (2%) out of the total fifty patients included in the study when oral Azithromycin was administered one hour prior to surgical removal of mandibular third molar. Our study suggests that, giving antibiotics pre-operatively 1 hour before the SRMTM is beneficial to reduce/avoid SSI. The surgeon must consider all potential factors that may contribute to the post-operative complication and decide whether the benefits of antibiotic therapy outweigh its risks.