Concentration of some prophylactic antibiotic in blood, dentoalveolar blood and mandibular bone in impaction surgery

ABSTRACT

Surgical removal of impacted third molars might be followed by infection. To fight against such infection an adequate antibiotic concentration should be there at the local tissue before the operation. This study was conducted to identify the level of single oral dose of prophylactic antibiotic in antecuhital serum, dentoalveolar serum and mandibular bone in impaction surgery. This study included 200 patients. divided into five groups each comprised forty patients and each group received single oral dose of one antibiotic under investigation [azithromycin. clindamycin. doxycycline. erythromycin, and penicillin-V]. Each group was further subdivided into eight subgroups comprising 5 patients according to the proposed time intervals. Antibiotics were taken 30. 60, 90. 120. 150. 180. 210, and 240 minutes before the operation according to the tested subgroup. Samples of blood. dentoalveolar blood and mandibular bone were taken at the planed time intervals. The concentrations of antibiotic in these samples were assayed in vitro by the agar diffusion [cup plate] method. The result showed that penicillin-V showed the highest mean peak serum concentration followed by doxycycline and clindamycin. However. all antibiotics gave measurable level exceeding the NBC of the tested bacterial isolates. Doxycycline showed the highest concentration ratio [bone/serum]. followed by penicillin-V, clindamycin and erythromycin. Up to four hours [240 minutes] no measurable level of azithromycin concentration could be attained in bone, so a further study at a longer time period [more than 12 hours] may be indicated. The suggested time for prophylactic use of the tested antibiotic should he two hours before the operation for clindamycin [300 mg]. one and half hour before the operation for erythromycin [500 mg]. three hours before the operation for doxycycline [200mg.] and half an hour before the operation for penicillin [937.5m2]