Short-term antibiotic prophylaxis in implant surgery: a comparison of three antibiotics

To investigate the efficacy, tolerability and cost effectiveness of three antibiotics in a short-term antibiotic regimen in patients undergoing elective implant surgery.

89 patients who underwent 101 implantation procedures were enrolled during a period of five years and randomly divided into three groups to receive: (a) Rocephin (Ceftriaxone) 1g intravenously at induction and 1g 12 hours later (Group 1). (b) Zinacef (Cefuroxime) 1.5 g intravenously at induction and 750 mg six hourly for 12 hours (Group 2). Ciprotab (ciprofloxacine) 400mg intravenously at induction and 200mg six hourly for 12 hours (group 3).

The patients in the three groups were comparable regarding age, gender, pre-operative length of hospitalization and duration of surgery. The overall surgical site infection rate was 6.9% (7/101) with gram-negative organisms being the most common causative organisms (71.4%). The infection rates of 6.3% in group 1,7.3% in group 2 and 7.1% in group 3 show no statistical significance (P>0.05). The cost benefit ratio for the three drugs showed that treatment with Ciprotab was cheaper than that with Rocephin or Zinacef. Severe complications warranting discontinuation of therapy did not occur in any of the three groups of patients.

While we can safely conclude that all the drugs have similar efficacy and safely in preventing post-operative wound complications, it appears that Ciprotab is most cost-effective. We recommend that a larger study be undertaken to confirm the predominance of gram-negative organisms in implant surgery.