Randomized study of surgical prophylaxis in immunocompromised hosts.

Area of Science:

• Oral Surgery
• Infectious Disease
• Oncology

Background:

• Antimicrobial prophylaxis is standard for invasive dental procedures in immunocompromised patients.
• No randomized controlled trials (RCTs) exist for chemotherapy or organ transplant recipients.

Purpose of the Study:

• To evaluate the efficacy of one versus two doses of oral amoxicillin prophylaxis.
• To assess outcomes in cancer and solid organ transplant patients undergoing invasive dental procedures.

Main Methods:

• 414 immunocompromised patients were randomized into a 1-dose or 2-dose amoxicillin group.
• Procedures included exodontia and periodontal scaling/root planing.
• Follow-up was conducted over 4 weeks.

Main Results:

• No deaths or surgical site infections were reported.
• Six patients (1.4%) required pain medication or hospitalization: 4 (2%) in the 1-dose group and 2 (1%) in the 2-dose group.
• Relative risk for adverse events was 2.02 (95% CI, 0.37-11.15).

Conclusions:

• No statistically significant difference in outcomes was observed between one and two doses of prophylactic amoxicillin.
• Both regimens appear safe and effective for invasive dental procedures in this patient population.