amoxicillin-potassium-clavulanate-combination and Pain--Postoperative

To compare the effectiveness of different oral antibiotics for prevention of dry socket and infection in adults following the surgical extraction of teeth under LA.. This randomized controlled study was conducted from 10 September 2020 until 10 May 2021. Forty-six patients were randomly allocated to three groups. Sixteen patients were in the postoperative co-amoxiclav (625 mg) group, fifteen in the preoperative co-amoxiclav (625 mg) plus postoperative metronidazole (500 mg) group and fifteen in the preoperative co-amoxiclav (625 mg) plus postoperative amoxicillin (500 mg) group. Evaluation of the postoperative signs of alveolar osteitis and infection was made by a dental surgeon five days postoperatively. Evaluation of the post-surgical extraction pain was made by patients immediately and five days postoperatively on standard 100 mm visual analogue scales (VAS). Furthermore, difficulty of surgery was recorded for all patients immediately postoperatively using (VAS).. all antibiotics used in this study were effective. Only 15% of patients had painful alveolar osteitis and 2% had oral infections. There was no significant decrease in the number of patients with severe alveolar osteitis or infection for co-amoxiclav plus metronidazole and co-amoxiclav plus amoxicillin groups compared to co-amoxiclav group at 5 days post-operation (. Administration of a single preoperative dose of co-amoxiclav with a full postoperative dose of amoxicillin or metronidazole was more effective than conventional treatment with postoperative co-amoxilcalv in reducing the incidence of both alveolar osteitis and infection after surgical extractions. However, these differences were not statistically significant. Interestingly, patients in metronidazole group had the lowest incidence of dry socket.

Topics: Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Dry Socket; Humans; Metronidazole; Molar, Third; Pain, Postoperative; Postoperative Complications

Tooth 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 postextraction local complications and whether the use of a probiotic could help reduce the antibiotic gastro-intestinal side effects.. One hundred eleven 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 g/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 extraction.. At 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.. Postextractive 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 gastrointestinal side effects, such as abdominal distension and diarrhea, which seemed to be relieved by the concomitant use of the probiotic.

Topics: Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Antibiotic Prophylaxis; Bifidobacterium longum; Diarrhea; Dry Socket; Female; Humans; Ibuprofen; Lactoferrin; Male; Middle Aged; Pain, Postoperative; Postoperative Complications; Probiotics; Surgical Wound Infection; Tooth Extraction; Treatment Outcome

To compare the efficacy of three different antibiotic regimens in reducing early dental implant failure.. In a controlled clinical trial, 270 consecutively treated patients were allocated to three antibiotic groups, alternatively, according to order of participation in the trial: Group A (2 g amoxicillin single preoperative dose), Group B (single preoperative 2 g amoxicillin followed by 500 mg three times daily for 5 days) and Group C (postoperative amoxicillin with clavulanic acid 625 mg three times daily for 5 days). Outcomes were pain, wound infection, dehiscence, adverse events possibly related to antibiotics and early implant failure. The patients were followed postoperatively at 1 week, 1 month and at the beginning of the prosthetic stage. Chi-square test and ANOVA test were used to examine differences.. In total, 240 patients were adherent to the trial protocol: Group A, 73 patients (210 implants); Group B, 79 patients (266 implants); and Group C, 88 patients (290 implants). Patients experiencing early implant failure: 12 in Group A (16.4%), 11 in Group B (13.9%) and 13 in Group C (14.8%). No statistically significant differences were observed for any of the outcome measures between the three groups.. It may not be necessary to provide postoperative antibiotics in patients undergoing dental implant placement, however, these preliminary findings need to be confirmed by large multicentre clinical trials.

Topics: Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Analysis of Variance; Anti-Bacterial Agents; Antibiotic Prophylaxis; Chi-Square Distribution; Clavulanic Acid; Dental Implantation, Endosseous; Dental Restoration Failure; Drug Combinations; Female; Humans; Male; Middle Aged; Pain, Postoperative; Postoperative Care; Preoperative Care; Surgical Wound Dehiscence; Surgical Wound Infection

To evaluate the efficacy of speech therapy for relief of post-tonsillectomy pain in children.. Fifty patients who underwent tonsillectomy and were randomly divided into three groups were analyzed in this study. Groups I and II received medical and speech therapy including two different phonemes group, and Group III received only medical therapy. For Group I (20 patients) soft palate phonemes and for Group II (20 patients) lips and gingival phonemes were used. The patients who received medical treatment without speech therapy were used as the control group. Postoperative pain levels were recorded with our standard visual analog scale (VAS) forms for each patient during the postoperative 10 days. The pain score of the patients were compared statistically among the three different groups.. The postoperative pain score was lower in Group I as compared to Group II (p=0.001) and III (p=0.045), and it was statistically significant. There was no significant difference regarding postoperative pain scores between Group II and Group III patients (p=0.356).. Speech therapy may cause to strengthen the soft palate muscles and alleviate constant post-tonsillectomy pain. This therapy may be used as a complementary treatment with standard analgesics.

Topics: Acetaminophen; Adolescent; Amoxicillin-Potassium Clavulanate Combination; Analgesics, Non-Narcotic; Anti-Bacterial Agents; Child; Child, Preschool; Female; Humans; Male; Pain Measurement; Pain, Postoperative; Prospective Studies; Single-Blind Method; Speech Therapy; Tonsillectomy

The most common complications after surgical extraction of the third mandibular molar are trismus, oedema or swelling, local pain, dysphagia and infection. The aim of this comparative, double-blind, randomized clinical trial was to evaluate the efficacy of two sustained release amoxicillin/clavulanate regimens in the reduction of infection after third molar extractive surgery. A total of 225 patients were randomized into three equal groups: placebo, prophylaxis with single pre-surgical dose of two tablets amoxicillin/clavulanate 1000/62.5 mg, and pre-emptive post-surgery therapy with two tablets amoxicillin/clavulanate 1000/62.5 mg BID for 5 days. A higher rate of infection (P=0.006) was found among patients receiving placebo (16%) than those receiving single-dose prophylaxis (5.3%) or 5-day pre-emptive therapy (2.7%). A relationship between both the duration (13.8% for long versus 7.4% for medium versus 1.6% for short) and difficulty (12.7% with ostectomy versus 3.5% without ostectomy; P=0.011) of surgical procedure and incidence of subsequent infection was also observed. Both prophylactic and therapeutic regimens versus placebo achieved greater reduction of pain after surgery on day 3 (P=0.001). Logistic regression analysis revealed a risk of infection of 24%, 9% and 4% for ostectomy with placebo, prophylaxis and pre-emptive treatment, respectively, whereas it was 7%, 2% and 1% if ostectomy was not performed. Pre-emptive therapy with the oral sustained release amoxicillin/clavulanate formulation reduced the rate of subsequent infection in patients undergoing ostectomy. Prophylaxis was beneficial in simpler procedures and may be indicated in cases where ostectomy is not performed.

Topics: Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Case-Control Studies; Deglutition Disorders; Delayed-Action Preparations; Double-Blind Method; Edema; Female; Fever; Humans; Male; Middle Aged; Molar, Third; Osteotomy; Pain, Postoperative; Placebos; Postoperative Complications; Risk Factors; Surgical Wound Infection; Tooth Extraction; Treatment Outcome; Trismus

The purpose of this study was to identify the risk factors for severe discomfort after mandibular third molar surgery and to assess the validity of the Postoperative Symptom Severity (PoSSe) scale.. In a 2-year prospective study, a total of 255 unilateral impacted mandibular third molar teeth were surgically removed under local anesthesia by 3 surgeons. Standardized surgical and analgesic protocols were followed. At the review appointment, 1 week after surgery, all patients returned a completed follow-up questionnaire (PoSSe scale) and were evaluated clinically for postoperative pain (number of painkillers taken) and trismus (differences in mouth opening). Sixteen predictive variables were evaluated using stepwise logistic regression analysis to identify the risk factors associated with severe discomfort.. Severe postoperative discomfort was predicted by these independent variables: gender, tobacco use, ramus relationship/space available, and antibiotic prophylaxis. Oral contraceptive use and operation time were not identified as risk factors. The patients' perceptions of the severity of symptoms (PoSSe scale score) was strongly correlated with clinical assessment of trismus (r = 0.54) and pain (r = 0.42).. The PoSSe scale resulted in a valid and responsive measure of the severity of symptoms after surgical extraction of lower third molars and reflected the clinical severity of the postoperative discomfort. From a patient's perspective, operative factors had little bearing on the quality of life after removal of mandibular third molars.

Topics: Adolescent; Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Female; Humans; Logistic Models; Male; Mandibular Condyle; Middle Aged; Molar, Third; Pain, Postoperative; Prospective Studies; Quality of Life; Reproducibility of Results; Risk Factors; Severity of Illness Index; Sex Factors; Single-Blind Method; Smoking; Surveys and Questionnaires; Tooth Extraction; Tooth, Impacted; Treatment Outcome; Trismus

We evaluated the need for prophylactic postoperative oral antibiotic treatment in the removal of asymptomatic third molars.. In a prospective study of more than 30 months, a total of 528 impacted lower third molars were surgically removed in 288 patients. All patients were referred to our department by a dentist or a general practitioner. No patient showed any sign of pain, inflammation, or swelling at the time of removal. Three groups were established. In the first group, antibiotic treatment with amoxicillin/clavulanic acid as an oral medication was carried out for 5 days postoperatively. In the second group, we used clindamycin. In the third group, the patients received no antibiotic treatment. Clinical and radiologic factors were recorded for each case, and the rationale for assigning the patients to the groups was strictly random. The surgical technique was the same in all cases, and the follow-up period was 4 weeks. Parameters that were evaluated were pain, differences in mouth opening, infection, the occurrence of dry socket, and adverse postoperative side effects.. We could not find any significant difference between the 3 groups regarding the evaluated parameters, but in 69.6% of the patients with dry socket, the teeth were partially erupted, which showed a significant difference.. The results of our study show that specific postoperative oral prophylactic antibiotic treatment after the removal of lower third molars does not contribute to a better wound healing, less pain, or increased mouth opening and could not prevent the cases of inflammatory problems after surgery, respectively, and therefore is not recommended for routine use.

Topics: Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Clindamycin; Dry Socket; Humans; Mandible; Middle Aged; Molar, Third; Pain, Postoperative; Postoperative Care; Prospective Studies; Surgical Wound Infection; Tooth Extraction

To investigate the effect of fusafungine spray on pain and healing process after pediatric tonsillectomy.. Sixty children with ages between 4 and 14 years underwent tonsillectomy or adenotonsillectomy. The patients were randomly divided into three groups and each group consisted of 20 patients. Group 1 was treated with antibiotic (amoxicillin-clavulanic acid) plus analgesic (acetaminophen), group 2 was treated with fusafungine plus analgesic (acetaminophen) and group 3 was treated with only fusafungine. The average ages were 7.8 + 3.4, 6.6 + 2.9, and 8.2 + 3.7 for groups 1, 2, and 3, respectively. Clinical evaluations were made after the operation on the 1st (T1), 3rd (T3), 7th (T7), 10th (T10), and 14th days (T14).. There was no significant difference in post-operative pain between study groups on the post-operative 1st, 3rd, and 7th days (P > 0.05), a statistically significant difference was present between groups 1 and 3, and groups 1 and 2 on the post-operative 10th and 14th day (P = 0.018 and 0.037, respectively). Pain was less in groups 2 and 3 than in group 1 on the 10th and 14th day. Also there was a significant difference in healing time of the tonsillary beds between groups 1 and 2, and groups 1 and 3 on the 10th and 14th post-operative day (P = 0.031 and 0.001, respectively). Healing was better in groups 2 and 3 than in group 1 on the 10th and 14th day.. Fusafungine administration after tonsillectomy was found to be beneficial on post-operative pain and wound healing of tonsillary beds in pediatric population.

Topics: Acetaminophen; Adolescent; Aerosols; Amoxicillin-Potassium Clavulanate Combination; Analgesics, Non-Narcotic; Anti-Bacterial Agents; Case-Control Studies; Child; Child, Preschool; Depsipeptides; Drug Therapy, Combination; Female; Fusarium; Humans; Male; Pain, Postoperative; Tonsillectomy; Treatment Outcome; Wound Healing

Chronic pilonidal disease is a debilitating condition that typically affects young adults. There is a wide variety of available therapeutic strategies reflecting the inconsistent outcomes attributed to the various operative approaches. The majority involve excision of the sinus tract followed by either primary closure or healing by secondary intention. A variety of closure approaches exist. There remains uncertainty as to which is more effective. The aim of the current study was to determine subjective and objective outcomes following excision and Karydakis flap closure in a unit where this technique is the standard of care in the management of chronic pilonidal disease.. This study involving consecutive patients with chronic pilonidal disease was conducted over a 4-year period. A tailored patient satisfaction questionnaire was given to each patient. Postoperative primary and secondary outcomes were evaluated. The mean follow-up time was 30 months.. One hundred six consecutive patients (33 female, 73 male) underwent excision and primary closure using the Karydakis flap. Ninety-two completed questionnaires were returned (87% response rate). Patients consulted their general practitioner 2.8 times (mean) and 46% received empirical oral antimicrobial therapy prior to referral for a surgical opinion. The mean time lost to work/school following the Karydakis flap repair was 13 days (range 3-33). Successful treatment was achieved in 96.3% of cases and 92% of patients were satisfied with their operative result.. Excision and primary closure with Karydakis flap is an effective treatment for chronic pilonidal disease. It is associated with low morbidity, early return to premorbid functioning, and a high degree of patient satisfaction (92%).

Topics: Abscess; Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Female; Germany; Humans; Male; Middle Aged; Pain, Postoperative; Patient Satisfaction; Pilonidal Sinus; Postoperative Complications; Surgical Flaps; Surveys and Questionnaires; Suture Techniques; Young Adult

Guided tissue regeneration procedures with Gore-Tex Periodontal Material are associated with a unique set of postoperative healing characteristics. Five healing complications are described in this study examining 102 sites. The occurrence of pain and purulence were the most common. In purulent sites, the majority of bacteria cultured were Actinomyces and Streptococcus spp. Resistance to antibiotics was common. Prevention and treatment of the healing complications are discussed.

Topics: Actinomyces; Adolescent; Adult; Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Chi-Square Distribution; Clavulanic Acids; Doxycycline; Drug Resistance, Microbial; Drug Therapy, Combination; Edema; Female; Furcation Defects; Gingival Diseases; Guided Tissue Regeneration, Periodontal; Humans; Male; Membranes, Artificial; Microbial Sensitivity Tests; Middle Aged; Pain, Postoperative; Periodontitis; Polytetrafluoroethylene; Postoperative Complications; Prevotella intermedia; Streptococcus; Suppuration; Surgical Flaps; Wound Healing