Extraction Socket Grafting and Ridge Augmentation Failures Associated with Clindamycin Antibiotic Therapy: A...

Area of Science:

• Dental surgery
• Infectious disease epidemiology
• Pharmacology

Background:

• Bone augmentation procedures, including socket grafting (SG) and ridge augmentation (RA), are common in dental implantology.
• Antibiotic prophylaxis is standard for these procedures, with amoxicillin and clindamycin being common choices.
• Penicillin allergy is a frequent concern, often leading to the prescription of alternative antibiotics like clindamycin.

Purpose of the Study:

• To investigate the association between penicillin allergy and clindamycin therapy with postsurgical infection rates following bone augmentation.
• To compare the incidence of infections in patients receiving amoxicillin versus clindamycin for antibiotic prophylaxis.

Main Methods:

• A retrospective study analyzed 1,814 patients undergoing 2,961 bone augmentation procedures (2,530 SG, 431 RA) between 2014 and 2019.
• Patients received either amoxicillin or clindamycin for preoperative and postoperative antibiotic coverage.
• Infection rates associated with bone augmentation were recorded and compared between antibiotic groups and allergy status.

Main Results:

• Infections occurred in 3.6% of SG procedures and 7.2% of RA procedures.
• For SG, the infection rate was 10.7% with clindamycin versus 2.7% with amoxicillin (P < .02).
• For RA, the infection rate was 22.5% with clindamycin versus 4.2% with amoxicillin (P < .01). Penicillin-allergic patients on clindamycin had a significantly higher risk of infection.

Conclusions:

• Penicillin allergy combined with clindamycin use is associated with a higher incidence of postsurgical infections after socket grafting and ridge augmentation.
• Clindamycin therapy in penicillin-allergic patients may represent a risk factor for complications in bone augmentation procedures.
• These findings suggest a need to reconsider antibiotic choices for penicillin-allergic patients undergoing bone augmentation to minimize infection risk.