Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain.
Department of Microbiology, Microbiology and Infectology Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur) SERGAS-Universidade de Vigo, Complexo Hospitalario Universitario de Vigo (CHUVI), Sergas, Vigo, Spain.
Oral Dis. 2023 Jul;29(5):2272-2276. doi: 10.1111/odi.14221. Epub 2022 May 13.
This study aimed to evaluate the effectiveness of oral amoxicillin/clavulanate (AMX-CL) for the prevention of bacteremia following dental extractions. The study group (AMX-CLG) comprised 40 adults requiring dental extractions under general anesthesia who were administered a prophylactic regimen of 1875/125 mg of AMX-CL orally 1-2 h prior to the surgery. Venous blood samples were collected from each patient at baseline and at 30 s and 15 min after dental extractions. Samples were inoculated into BACTEC Plus culture bottles and processed in the BACTEC 9240. Conventional microbiological techniques were used for subcultures and further identification of the isolated bacteria. The results for the AMX-CLG were compared with those of a control group (CG; no prophylaxis) and an amoxicillin group (AMXG; 2 g of amoxicillin orally), consisting of randomly selected patients from among those participating in two clinical trials that we have previously published. The prevalence of bacteremia in the CG, AMXG, and AMX-CLG was 97%, 50%, and 15%, respectively, at 30 s after completing the extractions, and 67%, 10%, and 4% at 15 min, respectively, after the last extraction. The prevalence of bacteremia in the AMXG and the AMX-CLG at 30 s and at 15 min after completing the extractions was significantly lower than that in the CG (p < 0.001 and p < 0.001, respectively; Fisher's exact test). The prevalence of bacteremia in the AMX-CLG at 30 s after completing the extractions was significantly lower than that in the AMXG (p < 0.001; Fisher's exact test). Based in the results of this preliminary study, oral AMX-CL could be an excellent option for preventing bacteremia secondary to dental procedures in patients at risk.
本研究旨在评估口服阿莫西林/克拉维酸（AMX-CL）预防拔牙后菌血症的效果。研究组（AMX-CLG）由 40 名在全麻下接受拔牙的成年人组成，他们在手术前 1-2 小时口服 1875/125mg 的 AMX-CL 进行预防。从每位患者基线和拔牙后 30 秒和 15 分钟时采集静脉血样本。将样本接种到 BACTEC Plus 培养瓶中，并在 BACTEC 9240 中处理。使用常规微生物技术进行亚培养和进一步鉴定分离细菌。将 AMX-CLG 的结果与对照组（CG；无预防）和阿莫西林组（AMXG；口服 2g 阿莫西林）进行比较，这两组是从我们之前发表的两项临床试验中随机选择的患者。CG、AMXG 和 AMX-CLG 在拔牙后 30 秒时的菌血症发生率分别为 97%、50%和 15%，拔牙后 15 分钟时分别为 67%、10%和 4%。AMXG 和 AMX-CLG 在拔牙后 30 秒和 15 分钟时的菌血症发生率明显低于 CG（p<0.001 和 p<0.001，Fisher 精确检验）。AMX-CLG 在拔牙后 30 秒时的菌血症发生率明显低于 AMXG（p<0.001；Fisher 精确检验）。基于这项初步研究的结果，口服 AMX-CL 可能是预防有风险的患者牙科手术后菌血症的绝佳选择。
