A Comparison of a Combination of Pre-Emptive Amoxicillin and Clavulanic Acid and Combination of Post Operative Amoxicillin+ Clavulanic Acid for Prevention of Post Operative Complications in Surgical Dental Extractions: A Prospective Study

Abstract

Background: Oral antibiotics are crucial after surgical extraction in order to accelerate the healing process. There is still a lack of substantial evidence supporting the use of preoperative oral antibiotics for reducing complications following the surgical removal of teeth.

Materials and methods: The participants were divided into 2 groups based on the analgesic used preemptively or postoperatively: Group 1- pre operative amoxicillin 500 mg+clavulanic acid 125mg and post operative amoxicillin 500 mg+clavulanic acid 125mg (n=20) and Group 2: post operative amoxicillin 500 mg+clavulanic acid 125mg (n=20). Post operative pain was measured using the Visual Analog Scale (100mm) from post operative day 1 to post operative day 5.

Results: Post operative pain from POD 1 to POD 5 significantly reduced in the group taking pre operative and post operative amoxicillin 500 mg+clavulanic acid 125mg. The mean VAS score reduction was statistically significant. (p=0.02) 10% (2 patients) and 15 % (3 patients) in the pre operative + post operative amoxiclav group developed dry socket and infection respectively. On the other hand in the post operative Amoxiclav group, 15% (3 patients) developed dry socket and 20% (4 patients) developed infection. Clinically the complications were more in the only post operative amoxiclav group but it was not statistically significant.

Conclusion: Clinically, this study showed that the administration of a single preoperative dose of amoxicillin 500mg+ clavulanic acid 125mg along with a full postoperative dose was more effective than conventional treatment with only post operative coverage for reducing the incidence of complications post surgical extractions. However these results were not statistically significant.