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Evaluation of intravenous prophylaxis antibiotics for third molar extraction under general anesthesia

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Abstract

Prophylactic antibiotic administration aims to maintain the postoperative wound environment. It is difficult to select appropriate prophylactic antibiotics to minimize the development of antibiotic resistant bacteria and the occurrence of complications. The purpose of this study was to compare the prophylactic effect of narrow spectrum antibiotics (cefazolin) with that of wide spectrum antibiotics (piperacillin) in preventing infection following third molar extraction. In addition, the effect of postoperative cefazolin administration was examined. This retrospective study included 350 patients who underwent third molar removal under general anesthesia. The patients were divided into three subgroups: preoperative cefazolin (N = 122), pre- and postoperative cefazolin (N = 101), and pre- and postoperative piperacillin (N = 127). The patients in the piperacillin group were administered the antibiotic preoperatively and postoperatively for 3 days. The patients in the preoperative cefazolin group were administered cefazolin preoperatively only. The patients in the pre- and postoperative cefazolin group were administered cefazolin preoperatively and postoperatively for 1 day. Surgical site infections (SSIs) were identified based on the Clavien–Dindo 30-day postoperative classification. There was a significant difference among the three groups of patients who had third molars classified as position C using the Pell and Gregory classification, according to the degree of impaction of the impacted third molar (P = 0.015). Our analysis showed that the number of SSI did not significantly differ between the three antibiotic treatment groups (P = 0.671). These results suggest that preoperative administration of cefazolin is as effective as postoperative administration of broad-spectrum antibiotics such as piperacillin.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Clinical Medicine, Department of Oral and Maxillofacial Surgery, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan

    Ran Iguchi, Akinori Moroi, Yuki Saito, Akihiro Takayama, Ryota Hiraide, Kunio Yoshizawa & Koichiro Ueki

  2. Division of Medicine, Department of Health Sciences, Basic Science for Clinical Medicine, Graduate School Department of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan

    Ryota Hiraide

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  1. Ran Iguchi
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  2. Akinori Moroi
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  3. Yuki Saito
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  4. Akihiro Takayama
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Contributions

RI and AM: conception and design of the study. RI, YS, AT: collection and assembly of data. AM and RH: analysis and interpretation of data. AM: drafting of the articles. KY: critical revision of the article. KU: final approval of the article.

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Correspondence to Akinori Moroi.

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The authors declare that they no conflict of interest.

Ethical approval

This study was performed in accordance with the Declaration of Helsinki, and the study was approved by the ethics committee of Yamanashi University Hospital, Yamanashi Prefecture, Japan (No. 2008).

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Iguchi, R., Moroi, A., Saito, Y. et al. Evaluation of intravenous prophylaxis antibiotics for third molar extraction under general anesthesia. Odontology 108, 681–687 (2020). https://doi.org/10.1007/s10266-020-00492-1

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  • DOI: https://doi.org/10.1007/s10266-020-00492-1

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