The role of preoperative prophylactic antibiotic administration in periapical endodontic surgery: a randomized, prospective double-blind placebo-controlled study.
OBJECTIVE
To determine the value of clindamycin prophylaxis in the prevention of postoperative wound infections in patients undergoing endodontic surgery.


METHODS
This study included 256 patients undergoing endodontic surgery in a prospective double-blind placebo-controlled trial comparing oral administration of an oral placebo versus a preoperative 600 mg dose of clindamycin. After randomization the study medication was administered orally 1 h before surgery in a double-blind fashion. For a period of 4 weeks the postoperative course was observed according to clinical parameters of infection. Primary end-point was infection at the surgical site.


RESULTS
The mean age of the study population was 44.4 years (SD 11.4, range 18-82 years) with a sex distribution of 147 females (47.4%) and 109 males (42.6%). Mean age of the patients in the clindamycin group was 44.7 years (SD 12.0), and the mean age in the placebo group was 44.1 years (SD 10.8) (P = 0.49). In the clindamycin group, the mean duration of surgery was 32.3 min (SD 8.8) and in the placebo group the mean duration of surgery was 32.5 min (SD 8.4) (P = 0.89). Two infections [1.6%; 95 confidence interval (CI): 0.48-4.72] were identified in the clindamycin group and four (3.2%; 95 CI: 0.42-1.33) in the placebo group (P = 0.448).


CONCLUSIONS
No statistically significant difference was found between clindamycin prophylaxis and placebo with regard to the prevention of postoperative infection in endodontic surgical procedures.
Lindeboom
J A H
JA
Department of Oral and Maxillofacial Surgery, Academic Medical Centre Amsterdam and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands. j.a.lindeboom@amc.uva.nl
Frenken
J W H
JW
Valkenburg
P
P
van den Akker
H P
HP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001047:Apicoectomy; D002981:Clindamycin / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008768:Methylmethacrylates / Q000627:therapeutic use; D008875:Middle Aged; D010485:Periapical Periodontitis / Q000601:surgery*; D010919:Placebos; D011300:Preoperative Care; D011446:Prospective Studies; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D013530:Surgical Wound Infection / Q000517:prevention & control; D013997:Time Factors; D015035:Zinc Oxide-Eugenol Cement / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D008768:Methylmethacrylates; D010919:Placebos; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; D002981:Clindamycin; C031667:IRM cement