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Antibiotic treatment to prevent post-extraction complications: a monocentric, randomized clinical trial. Preliminary outcomes.
Minerva Stomatol. 2017 May 31. doi: 10.23736/S0026-4970.17.04047-X. [Epub ahead of print]
extraction is a very common procedure in oral surgery. Despite this,
very little information is available in the literature as to the
antibiotic management of the patient. The aim of this study is to
evaluate whether the antibiotic prophylaxis could be beneficial in
preventing post- extraction local complications and whether the use of a
probiotic could help reduce the antibiotic gastro-intestinal side
MATERIALS AND METHODS:
patients meeting the inclusion criteria were initially included in this
randomized clinical trial and randomly allocated to one of the three
experimental groups according to a computer-generated randomization
list. Patients allocated to the group 1 were given
amoxicillin+clavulanic acid (2 grams/day for 6 days), patients allocated
to the group 2 received antibiotic+ probiotic (Bifidobacterium longum +
lactoferrin) and patients allocated to the group 3 received no
antibiotic therapy after the extraction. To evaluate post-extractive
complications, controls were performed at days 7, 14 and 21 after the
T1 pain at the surgical site was present in the 48%, 30% and 71.4% of
the patients belonging respectively to the antibiotic alone group, to
the antibiotic+probiotic group and to the control group. The mean
Numeric Rating Score (NRS) score was 1.56±1.91, 1.08±1.93, 2.02±2.27
respectively (P=0.0498). Two patients belonging to the control group
experienced dry socket. In addition, 9 patients (33.3%) in the
antibiotic-alone group and 1 patient (2.7%) in the antibiotic+probiotic
group reported intestinal distension (p=0.0012), 7 days after surgery.
Finally, diarrhea was recorded in 5 patients of the antibiotic alone
group (18.5%), on the other hand, no patients of the
antibiotic+probiotic group and the control group reported diarrhea.
complications observed in each group have been mild and fast to
resolve. The antibiotic administration showed a decrease in pain
suffered by patients but a higher incidence of gastro-intestinal side
effects, such as abdominal distension and diarrhea, which seemed to be
relieved by the concomitant use of the probiotic.