Azithromycin as prophylaxis for the prevention of postoperative infection in impacted mandibular third-molar surgery

Area of Science:

• Oral surgery
• Infectious disease
• Pharmacology

Background:

• Antimicrobial resistance is a growing concern, necessitating strategies like rotational antibiotic use.
• Penicillins and cephalosporins are commonly used for oral infections and prophylaxis.
• Controlling antimicrobial resistance requires exploring alternative prophylactic agents.

Purpose of the Study:

• To evaluate the clinical effectiveness of azithromycin prophylaxis in preventing postoperative infections after impacted mandibular third-molar surgery.
• To compare azithromycin's efficacy against traditional antibiotics in this surgical context.
• To assess azithromycin's potential role in antimicrobial rotational strategies.

Main Methods:

• Retrospective, single-center review of 45 patients undergoing impacted mandibular third-molar surgery.
• Analysis of postoperative infection rates, specifically dry socket infection.
• Comparison of azithromycin prophylaxis with other antimicrobial agents used previously.

Main Results:

• One case (2.2%) of dry socket infection was observed among all patients.
• Azithromycin demonstrated significant effectiveness in several categories compared to other antimicrobials.
• No statistically significant difference was found in the dry socket infection rate between azithromycin and other agents.

Conclusions:

• Azithromycin may be a beneficial prophylactic option for impacted mandibular third-molar surgery, particularly where penicillins and cephalosporins are standard.
• Its effectiveness in specific infection categories suggests potential utility in antimicrobial stewardship programs.
• Azithromycin could be considered as part of a rotational antibiotic regimen to combat resistance.