Efficacy of amoxicillin and amoxicillin/clavulanic acid in the prevention of infection and dry socket after third molar extraction: a systematic review and meta-analysis
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Efficacy of amoxicillin and amoxicillin/clavulanic acid in the prevention of infection and dry socket after third molar extraction: a systematic review and meta-analysis

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Efficacy of amoxicillin and amoxicillin/clavulanic acid in the prevention of infection and dry socket after third molar extraction: a systematic review and meta-analysis

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dc.contributor.author Arteagoitia Calvo, María Iciar es
dc.contributor.author Barbier Herrero, Luis es
dc.contributor.author Santamaría Zuazua, Joseba Andoni es
dc.contributor.author Santamaría Arrieta, Gorka es
dc.contributor.author Ramos, Eva es
dc.date.accessioned 2016-07-26T12:01:05Z
dc.date.available 2016-07-26T12:01:05Z
dc.date.issued 2016 es
dc.identifier.uri http://hdl.handle.net/10550/54800
dc.relation es
dc.source Arteagoitia Calvo, María Iciar ; Barbier Herrero, Luis ; Santamaría Zuazua, Joseba Andoni ; Santamaría Arrieta, Gorka ; Ramos, Eva. Efficacy of amoxicillin and amoxicillin/clavulanic acid in the prevention of infection and dry socket after third molar extraction: a systematic review and meta-analysis. En: Medicina oral, patología oral y cirugía bucal. Ed inglesa, 2016, Vol. 21, No. 4: 494- es
dc.subject Odontología es
dc.subject Ciencias de la salud es
dc.title Efficacy of amoxicillin and amoxicillin/clavulanic acid in the prevention of infection and dry socket after third molar extraction: a systematic review and meta-analysis es
dc.type info:eu-repo/semantics/article en
dc.type info:eu-repo/semantics/publishedVersion en
dc.subject.unesco UNESCO::CIENCIAS MÉDICAS es
dc.description.abstractenglish Background: Prophylactic use of amoxicillin and amoxicillin/clavulanic acid, although controversial, is common in routine clinical practice in third molar surgery. Material and Methods: Our objective was to assess the efficacy of prophylactic amoxicillin with or without clavulanic acid in reducing the incidence of dry socket and/or infection after third molar extraction. We conducted a systematic review and meta-analysis consulting electronic databases and references in retrieved articles. We included double-blind placebo-controlled randomized clinical trials published up to June 2015 investigating the efficacy of amoxicillin with or without clavulanic acid on the incidence of the aforementioned conditions after third molar extraction. Relative risks (RRs) were estimated with a generic inverse-variance approach and a random effect model using Stata/IC 13 and Review Manager Version 5.2. Stratified analysis was performed by antibiotic type. Results: We included 10 papers in the qualitative review and in the quantitative synthesis (1997 extractions: 1072 in experimental groups and 925 in controls, with 27 and 74 events of dry socket and/or infection, respectively). The overall RR was 0.350 (p<0.001; 95% CI 0.214 to 0.574). We found no evidence of heterogeneity (I2 =0%, p=0.470). The number needed to treat was 18 (95% CI 13 to 29). Five studies reported adverse reactions (RR=1.188, 95% CI 0.658 to 2.146, p =0.567). The RRs were 0.563 for amoxicillin (95% CI 0.295 to 1.08, p=0.082) and 0.215 for amoxicillin/clavulanic acid (95% CI 0.117 to 0.395, p<0.001). Conclusions: Prophylactic use of amoxicillin does not significantly reduce the risk of infection and/or dry socket after third molar extraction. With amoxicillin/clavulanic acid, the risk decreases significantly. Nevertheless, considering the number needed to treat, low prevalence of infection, potential adverse reactions to antibiotics and lack of serious complications in placebo groups, the routine prescription of amoxicillin with or without clavulanic acid is not justified es

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