azidocillin and Postoperative-Complications

Postoperative complications after surgical removal of mandibular third molars are still a clinical problem. Sixty patients undergoing operations for removal of an impacted third mandibular molar, were included in a double blind study. Phenoxymethylpenicillin 800 mg, azidocillin 750 mg, or placebo were given to the patients pre-operatively and then twice per day for the following seven days. The concentrations of phenoxymethylpenicillin and azidocillin in serum and alveolar serum were measured and the postoperative courses - pain, trismus, swelling and wound-healing - were recorded. The 40 patients in the antibiotic groups responded significantly better with respect to wound-healing than the 20 patients in the placebo group, and there were no differences between phenoxymethylpenicillin and azidocillin. Antibiotics significantly reduced pain on day 7 postoperatively. There were no differences between antibiotic groups and placebo with respect to trismus and swelling. When the dental alveolar serum concentrations of phenoxymethylpenicillin 3.0 microgram/ml and azidocillin 7.9 microgram/ml were related to their range of inhibitory concentrations for microorganisms isolated from orofacial infections, it was noticed that the two drugs achieved levels sufficient to inhibit most strains. The effect of phenoxymethylpenicillin and azidocillin on postoperative infections can be of value after traumatic oral surgery or after operations on patients especially susceptible to infections.

Topics: Adolescent; Adult; Aged; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Molar, Third; Penicillin G; Penicillin V; Penicillins; Postoperative Complications; Tooth Extraction; Tooth, Impacted

Treatment of osteitis after surgical removal of the third molar of the mandible is still a clinical problem. A total of 140 patients undergoing operations for removal of an impacted third molar of the mandible, were included in a double-blind study. Placebo or antibiotics - azidocillin, erythromycin, clindamycin and doxycycline - were given to the patients preoperatively and for the following 7 days. The concentrations in serum, alveolar serum and mandibular bone were measured and the postoperative courses - pain, trismus, swelling and wound-healing - were recorded. No correlation was obtained between the antibiotic concentration and the postoperative complaints, except in the azidocillin group on day 2, in which fewer complaints were noticed in patients with high concentrations of the drug at the time of operations. The 80 patients in the antibiotic groups responded significantly better with respect to wound-healing than the 60 patients in the placebo groups. Only 15 operations lasted more than 15 min and the three of them which subsequently resulted in alveolitis were in the placebo groups. Antibiotics significantly reduced pain on day 7 postoperatively. In general, no statistically significant differences in trismus and swelling could be demonstrated between the patient groups. However, there was a significant difference between the placebo and doxycycline groups with respect to swelling (day 2 postoperative, P < 0.01; day 5 postoperative, P < 0.05). Thus systemically administered antibiotics offered only slight advantages in routine operations of impacted third mandibular molars, but could decrease the rate of infections after traumatic operations.

Topics: Adolescent; Adult; Aged; Clindamycin; Clinical Trials as Topic; Double-Blind Method; Doxycycline; Dry Socket; Erythromycin; Female; Humans; Male; Middle Aged; Molar; Penicillin G; Penicillins; Placebos; Postoperative Complications; Tooth Extraction; Tooth, Impacted