Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong, China.
Eur Rev Med Pharmacol Sci. 2022 Jun;26(11):4016-4027. doi: 10.26355/eurrev_202206_28972.
The current review was designed to assess the efficacy of amoxicillin (AMX) and amoxicillin-clavulanic acid (AMX-CLA) for reducing infection rates after third molar surgery.
PubMed, Embase, ScienceDirect, and Google Scholar were searched for double-blind randomized controlled trials (RCTs) assessing the efficacy of AMX/AMX-CLA for infection control after third molar surgery.
13 RCTs were included. Our meta-analysis demonstrated a statistically significant reduced risk of infections with AMX/AMX-CLA (RR: 0.29, 95% CI: 0.18, 0.45 I2=0% p<0.00001). The meta-analysis demonstrated that the risk of infections was significantly reduced only in parallel-arm trials but not in split-mouth trials. Sub-group analysis based on antibiotic type indicated that the risk of infections was reduced with both AMX and AMX-CLA. A subgroup analysis based on the timing of AMX/AMX-CLA administration indicated that the risk of infections was significantly reduced with both preoperative (RR: 0.41, 95% CI: 0.21, 0.81 I2=0% p=0.01) and postoperative (RR: 0.18, 95% CI: 0.09, 0.35 I2=0% p<0.00001) administration of AMX/AMX-CLA. Meta-analysis indicated no increased risk of adverse events with the use of AMX/AMX-CLA (RR: 1.47, 95% CI: 0.41, 5.22 I2=77% p=0.55).
The use of AMX/AMX-CLA is associated with a significant reduction in the risk of infections after impacted third molar surgery. The risk of infections is reduced with both AMX and AMX-CLA. Our results also indicated that the infection risk was reduced with preoperative and postoperative antibiotic administration and there is no significant increase in the risk of antibiotic-related adverse events.
本综述旨在评估阿莫西林（AMX）和阿莫西林-克拉维酸（AMX-CLA）在降低第三磨牙手术后感染率方面的疗效。
在 PubMed、Embase、ScienceDirect 和 Google Scholar 上检索了评估 AMX/AMX-CLA 用于控制第三磨牙手术后感染的双盲随机对照试验（RCT）。
共纳入 13 项 RCT。我们的荟萃分析表明，使用 AMX/AMX-CLA 治疗可显著降低感染风险（RR：0.29，95%CI：0.18，0.45 I2=0% p<0.00001）。荟萃分析表明，仅在平行臂试验中，感染风险显著降低，而在分口试验中则没有。基于抗生素类型的亚组分析表明，AMX 和 AMX-CLA 均可降低感染风险。基于 AMX/AMX-CLA 给药时间的亚组分析表明，术前（RR：0.41，95%CI：0.21，0.81 I2=0% p=0.01）和术后（RR：0.18，95%CI：0.09，0.35 I2=0% p<0.00001）使用 AMX/AMX-CLA 均可显著降低感染风险。荟萃分析表明，使用 AMX/AMX-CLA 不会增加不良事件的风险（RR：1.47，95%CI：0.41，5.22 I2=77% p=0.55）。
使用 AMX/AMX-CLA 可显著降低第三磨牙阻生术后感染风险。AMX 和 AMX-CLA 均可降低感染风险。我们的结果还表明，术前和术后使用抗生素可降低感染风险，且抗生素相关不良事件的风险无显著增加。
