Comparison of three antibiotic protocols for prevention of infection in dental implant surgery: A randomized clinical trial

Summery: This study aimed to compare the rate of post-surgical infection following single-dose antibiotic prophylaxis with or without post-surgical antibiotics versus post-surgical administration of antibiotics alone. The study consisted of three groups; Group 1 received single-dose antibiotic prophylaxis orally (2 g amoxicillin 1 h before surgery). Group 2 received one dose of prophylactic antibiotic (2 g amoxicillin 1 h before surgery) with additional doses after surgery (500 mg amoxicillin, q8h for 5 days). Group 3 received post-surgical antibiotics alone (500 mg amoxicillin, q8h for 5 days). 450 patients were enrolled. Post-surgical infection was seen in 9 patients of group 1,11 patients of group 2, and 7 patients of group 3. There was no significant difference in the rate of postoperative infection among the study groups (p value = 0.62). The number of failed implants was 2 in group 2, and 1 in group 3. Subgroup analysis showed no significant difference in infection rates among the three groups regarding concomitant guided bone regeneration. However, there was a significant difference in the rate of post-surgical infection between smokers and non-smokers (p < 0.001). Within the limitations of the study, it seems that a single preoperative dose of antibiotics is sufficient for reducing surgical site infections, adequately and should be preferred after implant placement whenever appropriate. (C) 2022 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study compared the rate of post-surgical infection between single-dose antibiotic prophylaxis and the use of post-surgical antibiotics alone. The results suggest that a single preoperative dose of antibiotics is sufficient for reducing surgical site infections and should be preferred after implant placement whenever appropriate.