Use of antibiotics after lower third molar surgery - useful or harmful procedure? A randomized, double-blind, placebo-controlled trial

Abstract

Introduction/Objective. The aim of the present study was to investigate the effects of moxifloxacin and cefixime in preventing postoperative infection following mandibular third molar surgery. Methods. Double-blind study was completed by 157 patients undergoing surgical removal of mandibular third molars. The patients were randomly assigned to the following three groups: moxifloxacin (M), cefixime (C), and placebo (P). Patients in each group were classified into two subgroups: subgroup (a), without previous history of pericoronitis, and subgroup (b), with previous history of pericoronitis. All the patients were evaluated at the postoperative follow-ups on the first, second, and seventh postoperative day. Results. Postoperative infections were registered only in patients with a history of pericoronitis. Antibiotic prophylaxis with cefixime and moxifloxacin reduced the occurrence of postoperative infection. Overall incidence of postoperative infections was 6.4%. All postoperative infections were registered in the placebogroup, where the incidence of postoperative infection was 19.2%. Microbiological tests verified the clinically obtained results. Isolated microflora was resistant to penicillin-derived antibiotics in 50% of the cases. Conclusion. Prophylactic use of antibiotics after third molar surgery should be weighed against potential risks and benefits and could be considered in cases with previous history of pericoronitis, when complicated surgical extraction is performed.

Keywords

• third molar surgery
• antibiotic prophylaxis
• postoperative complications
• drug resistance
• microbial susceptibility tests