Antibi prophy / dental courses

INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

INTRODUCTION
 The term “prophylaxis” is a measure taken to maintain
health and prevent spread of disease
ANTIBIOTIC PROPHYLAXIS-
It is the treatment with antibiotics, beginning just
before surgery to minimise and or prevent
development of infection

 PERIOPERATIVE PROPHYLAXIS-
It refers to the period extending from time of
hospitalisation for surgery to time of discharge.
The most effective method of antibiotic prophylaxis is
preoperative administration of antibiotics as it can act
at the time when the wound is potentially
contaminated by bacteria
{ Yonsei med journal Feb-2009. 50(1): 55-59 }

Indian Dental academy
• www.indiandentalacademy.com
• Leader continuing dental education
• Offer both online and offline dental
courses

An appropriate prophylactic antibiotic should be-
1) Be effective against microorganisms anticipated to
cause infection
2) Achieve adequate tissue levels
3) Cause minimal side effects
4) Be relatively inexpensive

ANTIBIOTIC PROPHYLAXIS IN MAXILLOFACIAL
FRACTURES

( JOMS 2001., 1415-1419 )
PURPOSE-
 This study evaluated the difference between effect of
5-day course of oral antibiotics and a placebo on the
incidence of post-operative infection in uncomplicated
fractures of mandible.
 PATIENTS AND METHODS-
Thirty patients were assigned randomly in two groups
Group 1- received Penicillin 500 mg every 6 hourly for
five days
Group 2 – received placebo drugs for 5 days

RESULTS-
(2 0f 14 patients in group 1) and (2 of 16 patients of
group 2) developed infection.
No statistically significant difference in incidence of
infection was noted in two groups
CONCLUSION-
Use of Post operative oral antibiotics in uncomplicated
fractures of mandible had no benefit in reducing the
incidence of infection

 (J Oral Maxillofac Surg 64:576-582, 2006)
 PURPOSE-
To determine the necessity and / or effectiveness of
post-operative antibiotics in treatment of mandibular
fractures.
PATIENTS AND METHODS-
No. of patients - 291
All patients had Open mandibular fractures treated
with ORIF
Patients randomly selected into 2 groups whether or not
received post operative antibiotics
Both groups received Preoperative and intraopertive
antibiotic regimens
Followup between 5 and 8 weeks

 RESULTS
Of 291 patients ( 8 in Grp Ab and 14 in Grp non Ab)
noted infection within 8 week period
No statistically significant difference between two
groups
CONCLUSION-
This study could not prove any statistically significant
benefit to administration of post operative antibiotics
in mandible fracture treatment with ORIF.

(J Oral Maxillofac Surg 64:1664-1668, 2006 )
 PURPOSE-
A systematic review to find evidence for prophylactic
administration of antibiotics in treatment of
maxillofacial fractures
METHODS-
Four studies fulfilled requirements of being randomised
controlled trials
RESULTS-
A three-fold decrease in infection rate of mandible
fractures treated by antibiotic group.

 CONCLUSION-
A one-day administration of antibiotic prophylaxis
reduce infection in managemnt of mandible fractures
not involving condylar region

(J Oral Maxillofac Surg 67:827-832, 2009)
PURPOSE-
To determine whether or not extended prophylactic
antibiotic regimens for treatment of open or closed
reduction of mandible fractures is beneficial in
lowering rate of infection in post-operative patients
No of patients- 150 (complicated and uncomplicated
mandible fractures)
Group A- 75 patients received perioperative antibiotics
Group B- 75 patients received extended regimen

RESULTS-
Infection in group A- 13.33% and in group B- 10.67%
No statistically significant difference between two
groups
CONCLUSION-
Use of prophylactic antibiotic had no significant
difference on infection in management of
complicated and uncomplicated mandible fractures

ANTIBIOTIC PROPHYLAXIS IN INFECTIVE
ENDOCARDITIS

 CURRENT RECOMMENDATIONS FOR IE
PROPHYLAXIS-
IE prophylaxis for dental procedures is reasonable for
patients with underlying cardiac conditions with high
risk of adverse outcome from IE
Prophylaxis is reasonable for patients undergoing
manipulatio of gingival tissue and perforation of oral
mucosa
Prophylaxis not recommended in increased lifetime risk
of acquisition of IE

ANTIBIOTIC PROPHYLAXIS IN ORTHOGNATHIC
SURGERY

(J Med Assoc Thai 2008; 91 (11): 1726-31 )
Objective-
To evaluate prophylactic efficacy after correction of
dentofacial deformities between short term and long
term penicillin and amoxycillin- clavulinic acid.
MATERIALS AND METHODS-
Four groups were randomly assigned.
Short term and long term ( 5 days) penicillin and short
term and long term (5 days) amoxycillin-clavulinic
acid

 RESULTS
Totally 122 patients randomly assigned into four
groups.
Infection developed in a patient in short-term
amoxycillin-clavulinic acid group and long term
penicillin group
CONCLUSION-
No difference in infecton rate between two groups of
antibiotics.
Based on present study, short-term penicillin is
appropriate for prophylactic antibiotics in
orthognathic surgery

(J Oral Maxiliofac Surg.57:226-230, 1999)
 PURPOSE-
The infection rates of 1-day and 5-day administration of
prophylactic antibiotics in orthognathic surgery was
compared.
Thirty patients were chosen
Group 1 – received penicillin G- one million unit every 6
hours for 8 doses
Group 2- received placebo drugs with similar dosing
schedule
Wounds evaluated for infection according to CDC
criteria

 RESULTS-
One patient in group 1 (6.7%) and 9 patients in group 2
(60%)
Overall infection rate 33.3%
There is statistically significant difference in infection
rate between two groups
CONCLUSION-
Antibiotic prophylaxis for orthognathic surgical
procedures should continue after immideate
postoperative period.
FIVE DAYS of antibiotic administration appears to
provide adequate coverage

 (J Oral Maxillofac Surg57: 1403-l 406, 1999)
 PURPOSE-
To evaluate need for antibiotic prophylaxis in orthognathic
surgery
No.of patients- 54 underwent bimaxillary orthognathic
surgery
After randomisation, a placebo 2,200 mg amoxicillin-
clavulinic acid or cefuroxime-1500mg administered in a
double – blind fashion.
During first month, postoperative course was observed
according to clinical parameters infection, total leucocyte
count and ESR

 RESULTS-
Fifteen of 54 patients developed wound infection.
Of these 10 patients received placebo, 3 received
cefuroxime and 2 received amox-clav.
CONCLUSION-
There was statistically significant increased risk of
having an infectious bimaxillary orthognathic surgery
without antibiotic prophylaxis.
No significant difference in incidence of infectious
complication was found between two medications

PURPOSE-
To evaluate prophylactic value of single- dose
antibiotic prophylaxis on post operative infection in
patient undergoing orthognathic surgery compared to
single dose antibiotics
No.of patients- 150
Males-59 and females-93.
Divided into two groups of 75 each

Group1- Single-dose antibiotic prophylaxis was given
Group 2 – Single day of antibiotic prophylaxis was given
All patients assessed for rates of infection
postoperatively for orthognathic surgery
RESULTS-
Seven patients in group 1 and 2 patients in group 2
developed infection.

 CONCLUSION-
There is clinically significant difference but no
statistically significant difference between single-dose
and single day antibiotic prophylaxis

ANTIBIOTIC PROPHYLAXIS IN THIRD MOLAR
SURGERY

Does prophylactic administration of systemic
antibiotics prevent postoperative inflammatory
complications after third molar surgery?
Halpern et al.,
(JOMS FEB 2007., 177-185)

PURPOSE: To estimate and compare the frequencies of
inflammatory complications after third molar (M3)
surgery in subjects receiving intravenous prophylactic
antibiotics or saline placebo.
MATERIALS AND METHODS
a placebo-controlled, double-blind, randomized clinical
trial
The medication was administered intravenously prior to
any incision
The outcome variable was postoperative inflammatory
complication classified as present or absent and
included alveolar osteitis (AO) or surgical site
infection (SSI).

 RESULTS:
The sample was composed of 118 subjects (n = 59 per
study group). In the active treatment group, there were
no postoperative inflammatory complications. In the
placebo group, 5 subjects (8.5%) were diagnosed with
SSI
 CONCLUSION:
In the setting of third molar removal, these results
suggest that the use of intravenous antibiotics
administered prophylactically decrease the frequency
of SSIs.

(J Oral Maxillofac Surg 65:1909-1921, 2007)
PURPOSE-
 Author conducted a synthetic quantitative review of
the published clinical trials on the effectiveness of
antibiotic prophylaxis in third molar surgery.
Materials and Methods:
Electronic databases were searched for randomized
controlled trials
Primary outcome variables included alveolar osteitis
(AO) and surgical wound infection
 Extracted data were analyzed using a meta-analytical
program with a random-effect model

RESULTS
A total of 2,932 patients randomized in 16 clinical trials
reported AO as an outcome
 AO occurred in 84 of 1,350 patients in the treatment
group, a frequency of 6.2%; and in 228 of 1,582 patients
in the control group, a frequency of 14.4%.
 Systemic antibiotic therapy was effective in reducing
the risk of AO (odds ratio [OR], 2.175)
 A total of 2,396 patients randomized in 12 clinical
trials reported wound infection as an outcome.
 Wound infection occurred in 44 of 1,110 patients in the
treatment group, a frequency of 4%; and in 78 of 1,286
patients in the control group, a frequency of 6.1%.

 Systemic antibiotic therapy was effective in reducing
the risk of wound infection (OR, 1.794)
 Antibiotics reduced the risk of AO and wound
infection only when first dose was given before surgery
 Conclusion:
Systemic antibiotics given before the surgery were
effective in reducing the frequencies of AO and wound
infection after third molar surgery.

PURPOSE-
 This study evaluated the influence of antibiotic
prophylaxis on postoperative complications after inferior
third molar removal in young patients.
PATIENTS AND METHODS
 59 patients with a mean age of 15 years (range, 12-19 years).
 Patients were randomized into 2 groups, the test group
and the control group.
 The test group included 32 patients
 The control group included 27 patients
 Postoperative complications such as pain, swelling, wound
infection, and fever were recorded

 RESULTS-
The mean operating time was 34 minutes in the control
group and 31 minutes in the test group.
 In the test group there was a statistically significant
reduction of postoperative pain in the 7 days after the
extraction.
 Wound infection was a sequela reported in 4 patients
in the control group and in 1 patient in the test group;
this difference is statistically significant .

 CONCLUSION-
A statistically significant difference was found between
patients receiving preoperative amoxicillin
and the control group in the incidence of postoperative
pain, fever, and wound infection.
Another important finding was the statistically minor
consumption of analgesics in the test group in the
postoperative week.

ANTIBIOTIC PROPHYLAXIS IN OTHER
CONDITIONS

 Principles of Antibiotic Prophylaxis
 PRINCIPLE I: THE SURGICAL PROCEDURE
SHOULD HAVE A SIGNIFICANT RISK OF
INFECTION
 PRINCIPLE II: SELECT THE CORRECT ANTIBIOTIC
FOR THE SURGICAL PROCEDURE
 PRINCIPLE III: THE ANTIBIOTIC LEVEL MUST
BE HIGH

 PRINCIPLE IV:
TIME ANTIBIOTIC ADMINISTRATION CORRECTLY
(JOMS 1990., vol48: 617-620)

PURPOSE-
 To retrospectively show and value the outcomes of
dental implant treatment without antibiotic
prophylaxis.
 The study included 437 consecutively treated patients,
in whom a total of
 736 implants were placed. The population received no
prophylactic antibiotics,
 Healing was evaluated at second-stage surgery (4 to 6
months postoperatively)

 Results: The implant survival rate in the sample
(96.2%) was no lower than the high success rates
 published in the literature using various antibiotic
regimens
Conclusions:
These findings suggest that the use of antibiotics for
routine oral implants may not be beneficial
 The use of antibiotic prophylaxis before oral surgical
procedures remains a controversial issue,
 poorly documented in the literature.

Antibiotic prophylaxis in clean neck dissections.
Seven H, Sayin I, Turgut S
Ear, Nose, and Throat Department, Sisli Etfal Training
and Research Hospital, Istanbul, Turkey.
 J Laryngol Otol 2005 Mar;119(3):243; author reply 243-
4

 . A prospective series of 57 patients undergoing clean
neck dissections with the use of perioperative
ampicillin-sulbactam for 24 hours was compared with
an historical control group of 51 patients undergoing
clean neck dissections with no perioperative antibiotic
use.
 Two groups were chosen-
Study group
Control group

 Wound infection occurred in one patient (1.7 per cent)
in the study group and in seven patients (13.3 per cent)
in the control group, the difference was statistically
significant (p = 0.02).
 These data suggest that the use of a perioperative
antibiotic for 24 hours in patients undergoing clean
neck dissection results in significant reduction in the
incidence of post-operative wound infection.

THANK YOU

Antibi prophy / dental courses

Recomendados

Recomendados

Mais conteúdo relacionado

Mais procurados

Mais procurados (20)

Destaque

Destaque (20)

Semelhante a Antibi prophy / dental courses

Semelhante a Antibi prophy / dental courses (20)

Mais de Indian dental academy

Mais de Indian dental academy (20)

Último

Último (20)

Antibi prophy / dental courses