title: Randomized study of surgical prophylaxis in immunocompromised hosts.
abstract: Although prophylaxis is current practice, there are no randomized controlled studies evaluating preoperative antimicrobial prophylaxis in dental procedures in patients immunocompromised by chemotherapy or organ transplants. To evaluate prophylaxis in dental-invasive procedures in patients with cancer or solid organ transplants, 414 patients were randomized to receive one oral 500-mg dose 2 hours before the procedure (1-dose group) or a 500-mg dose 2 hours before the procedure and an additional dose 8 hours later (2-dose group). Procedures were exodontia or periodontal scaling/root planing. Follow-up was 4 weeks. No deaths or surgical site infections occurred. Six patients (1.4%) presented with use of pain medication > 3 days or hospitalization during follow-up: 4 of 207 (2%) in the 1-dose group and 2 of 207 (1%) in the 2-dose group (relative risk, 2.02; 95% confidence interval, 0.37-11.15). In conclusion, no statistically significant difference occurred in outcome using 1 or 2 doses of prophylactic amoxicillin for invasive dental procedures in immunocompromised patients.
authors.affiliation: Department of Infectious Diseases and LIM-54, University of São Paulo, Brazil.
authors.forename: D R
authors.initials: DR
authors.lastname: Lopes
authors.forename: M P S M
authors.initials: MP
authors.lastname: Peres
authors.forename: A S
authors.initials: AS
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods / Q000706:statistics & numerical data*; D001769:Blood / Q000382:microbiology; D017742:Dental Care for Chronically Ill; D012534:Dental Scaling; D004358:Drug Therapy; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016377:Organ Transplantation; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control; D014081:Tooth Extraction; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin