Prevalence of bacteraemia following dental extraction - efficacy of the prophylactic use of amoxicillin and clindamycin

Acta Odontol Scand. 2021 Jan;79(1):25-30. doi: 10.1080/00016357.2020.1768285. Epub 2020 May 25.

Abstract

Objectives: To evaluate the efficacy of single-dose antibiotic prophylaxis (AP) in the prevention of bacteraemia following tooth extractions at our clinic.

Material and methods: Fifty patients undergoing tooth extractions were enrolled. The need of AP was determined according to the health status and possible allergies of the patients. Blood culture samples were collected at baseline, 5 min after the first tooth extraction and 20 min after the last extraction.

Results: The majority (76%) received prophylactic oral amoxicillin or intravenous ampicillin (AMX/AMP) (2 g), 12% received clindamycin (CLI) (600 mg) and 12% received no prophylaxis (NO AP). All baseline blood cultures were reported negative. The prevalence of bacteraemia was significantly higher in the CLI and NO AP groups compared to the AMX/AMP group 5 min after the first tooth extraction (p < .0001 and p = .015, respectively). Twenty minutes after the last extraction positive blood cultures were reported only for CLI (p = .0015) and NO AP groups. There was no significant difference in the prevalence of positive blood cultures between CLI and NO AP groups.

Conclusions: Appropriately administered AMX/AMP proved its efficacy in reducing both the prevalence and duration of bacteraemia following tooth extractions whereas CLI was not effective in preventing bacteraemia following tooth extractions.

Keywords: Antibiotic prophylaxis; amoxicillin; bacteraemia; clindamycin; tooth extraction.

MeSH terms

  • Amoxicillin
  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis
  • Bacteremia* / drug therapy
  • Bacteremia* / epidemiology
  • Bacteremia* / prevention & control
  • Clindamycin*
  • Humans
  • Prevalence
  • Tooth Extraction / adverse effects

Substances

  • Anti-Bacterial Agents
  • Clindamycin
  • Amoxicillin