Eficacia de dosis única endovenosa de sultamicilina (unasyn IV) como antibioticoterapia profiláctica antes de la cirugía del tercer molar / Effectiveness of single dose of intravenous sultamicillin as prophylaxis antibotic therapy before the third molar surgery

El uso racional de los antimicrobianos es imperante para evitar la resistencia bacteriana, sin embargo, la antibioticoterapia profiláctica en la cirugía del tercer molar sigue siendo un tema controversial en cuanto a su administración y duración del tratamiento. Basándonos en las recomendaciones de la Sociedad Americana de Cardiología para profilaxis de endocarditis bacteriana, cuyo protocolo es una dosis única previa a la cirugía, nos planteamos el siguiente estudio, cuyo objetivo fue la evaluación clínica del uso endovenoso de una dosis única de SULTAMICILINA (UNASYNR IV) como antibioticoterapia profiláctica en la cirugía de terceros molares. Al efecto se seleccionó una muestra de 45 pacientes, masculinos y femeninos, de la sala clínica del Post Grado de Cirugía Bucal de la Facultad de Odontología de la Universidad Central de Venezuela con indicación de extracción de los terceros molares retenidos, quienes firmaron el consentimiento informado y fueron organizados en tres grupos de 15 pacientes bajo el siguiente esquema: Grupo A, al cual se le administró 1,5 g de UnasynR IV, Grupo B cuyos integrantes recibieron 3g de UnasynR IV y, por último, Grupo C, el cual fue el grupo control al que se le administró 500 mg de Amoxicilina por vía oral. Se realizaron 4 controles: a las 0 horas, a las 48 horas, 72 horas y a los 7 días. Los resultados obtenidos demostraron que todas las dosis fueron efectivas y no existió diferencia significativa entre los tres grupos estudiados (p>0,05). Por tanto, se recomienda el esquema de 1,5 gramos de Sultamicilina

The rational use of antimicrobials is imperative to avoid bacterial resistance; however, antibiotic prophylaxis in third molar surgery remains a controversial issue in terms of administration and duration of treatment. Based on the recommendations of the American Heart Association for prophylaxis of bacterial endocarditic, whose protocol is a single dose prior to surgery, we considered the following clinical trial aiming at clinical evaluation of intravenous use of a single dose of Sultamicillin as prophylactic antibiotic therapy in patients undergoing third molar surgery. For the development of this research, we used a sample of 45 male and female patients that attended to the Oral Surgery Graduate School of Dentistry, in the Central University of Venezuela, indicating extraction of the third molars, who signed informed consent and were organized into three groups of 15 patients under the following scheme: Group A which was administered with 1.5 g of Sultamicillin intravenously, Group B witch received 3 g of Sultamicillin intravenously, and finally Group C which was the control group who were given Amoxicillin 500 mg orally. Four controls were performed: at 0 hours, 48 hours, 72 hours and 7 days by direct clinical evaluation by the operator, where we evaluated the presence or absence of purulent exudate, oral hygiene, presence and degree of pain according to the Visual Analog Scale (VAS). Results showed the effectiveness of all doses and no significant difference between the three groups by Willcoxon (p> 0.05). Therefore we recommend the use of Sultamicillin 1,5 grams intravenously

Evaluation of postoperative prophylactic antibiotic medication in third molar surgery

We evaluated the need for prophylactic postoperative oral antibiotic medication in extraction of asymptomatic impacted mandibular third molars. All patient didn't show sign of pain, inflammation, swelling and trismus at the time of extraction. In the experimental group, oral antibiotic medication(Amoxicillin) was carried out for 5 days postoperatively. In the control group, the patients received no antibiotic medication. All groups didn't use antibiotic irrigation solution. Rule of group composition randomized. The surgical technique was the same in all cases. Parameters that were evaluated were infection, pain, facial swelling, trismus. We could not find any significant difference between the experimental and control groups.(P<0.05) The results of our study show that post operative oral prophylactic antibiotic medication after the extraction of impacted mandibular third molars does not contribute to less infection, pain, facial swelling and increased mouth opening after surgery. Therefore we suggest that prophylactic postoperative oral antibiotic medication is not needed in extraction of asymptomatic impacted mandibular third molars.