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

Authors

  • Emilia Marttila a Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
  • Lotta Grönholm b The Finnish Medicines Agency, Helsinki, Finland
  • Mikko Saloniemi a Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
  • Riina Rautemaa-Richardson c Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; d Department of Infectious Diseases and Mycology Reference Centre Manchester, Manchester University Hospitals NHS Foundation Trust, Manchester, UK

DOI:

https://doi.org/10.1080/00016357.2020.1768285

Keywords:

Antibiotic prophylaxis, bacteraemia, tooth extraction, amoxicillin, clindamycin

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.

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Published

2021-01-02