Penicillin concentration in the compact bone of the mandible

Area of Science:

• Oral and Maxillofacial Surgery
• Pharmacology
• Infectious Disease Prevention

Background:

• Surgical removal of impacted third molars can lead to oral wound infections.
• Penicillin G is a common antibiotic used in surgical prophylaxis.
• Understanding antibiotic concentrations in bone is crucial for effective prophylaxis.

Purpose of the Study:

• To determine penicillin G concentrations in mandibular compact bone after intravenous administration.
• To evaluate the efficacy of different single-dose regimens of penicillin G.
• To assess the potential of preoperative penicillin G infusion for preventing surgical site infections.

Main Methods:

• A prospective study involving 30 patients undergoing impacted third molar extraction.
• Patients received either 5 million IU or 10 million IU of penicillin G intravenously as a single pre-operative dose.
• Penicillin G concentrations in mandibular bone were measured during osteotomy.

Main Results:

• Bactericidal concentrations of penicillin G were detected in the mandibular bone in both dosage groups.
• The 10 million IU dose demonstrated higher effectiveness in certain patients compared to the 5 million IU dose.
• Significant interindividual variation in penicillin G levels was observed.

Conclusions:

• Preoperative single-dose intravenous penicillin G achieves therapeutic levels in mandibular bone during third molar surgery.
• A higher dose (10 million IU) may be more effective, considering factors like operation length and patient characteristics.
• This prophylactic approach holds promise for reducing the incidence of surgical wound infections in oral osteotomies.