ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title There Is No Difference In The Rates Of Third Molar Post-Operative Inflammatory Complications Between Patients With 600mg Clindamycin, and Patients Without Antibiotics
Clinical Question In a patient undergoing a third molar extraction, will a clindamycin prophylaxis prevent postoperative inflammatory complications compared to no postoperative antibiotics?
Clinical Bottom Line There is no difference in the rates of third molar post-operative inflammatory complications between patients with clindamycin, and patients without antibiotics. For immunocompetent patients undergoing third molar extractions, there is no apparent reason to provide any clindamycin antibiotic intervention. This is only based of a study conducted using 86 patients.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 17408924Kaczmarzyk/200786 patients needing third molar extractions.Randomized, double-blind, placebo controlled
Key results100 subjects were randomly assigned to one of 3 groups (1) single, 600mg pre-operative dose of oral clindamycin, (2) 600mg pre-operative clindamycin with 5 day continued administration of a 300 mg dose and, (3) a no clindamycin control group. Subjects were examined at 1, 2 and 7 days post-operatively. During the first two days after surgery, there were no statistical differences in the number of infections, trismus, facial swelling, and lymphoadenopathy between the groups. However, one week post-operative there was a statistical difference (P=0.03) in the body temperatures between the groups.
Evidence Search (("Clindamycin"[Mesh]) AND "Antibiotic Prophylaxis"[Mesh]) AND "Molar, Third/surgery"[Mesh]
Comments on
The Evidence
Validity: The study design was an RCT, with similar groups at the beginning of the study. There was an 86% completion rate and all groups were managed the same. The study was double blind, with adequate recall and compliance. Recall bias and competing interests are unlikely.
Applicability This would apply to patients needing third molar extractions. However, if said patients is immunocomprimised, antibiotic prophylaxis would still be necessary.
Specialty/Discipline (General Dentistry) (Oral Surgery)
Keywords Extraction, Third molar Extraction
ID# 2447
Date of submission: 04/08/2013spacer
E-mail gracem@livemail.uthscsa.edu
Author Matthew D. Grace
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ernest Valdez, DDS
Faculty mentor/Co-author e-mail valdeze@uthscsa.edu
Basic Science Rationale
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Comments on the CAT
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