Self-Reported Penicillin Allergy, Alternative Antibiotics, and Implant Outcomes: A Retrospective Study

The effects of self-reported penicillin allergy and alternative antibiotic regimens on implant outcomes remain poorly investigated. Therefore, the aim of this study was to evaluate the association between self-reported penicillin allergy and the use of alternative antibiotics with post-implant placement surgical complications, early implant failure, and preloading crestal bone loss (PLCBL).

This retrospective cohort study examined dental records of patients who received at least one dental implant. Patients who reported a penicillin allergy were identified as the exposed group, whereas patients without a reported penicillin allergy were selected as unexposed in a 1:2 exposed-to-unexposed ratio. Relevant patient- and implant-related factors were recorded. Implants were evaluated for postsurgical complications, PLCBL, and early failure. Data were analyzed using bivariate analyzes and mixed-effects regression models.

A total of 179 subjects and 374 implants were evaluated. Early implant failure and surgical complications occurred in 6.1% and 8.0% of implants, respectively, while PLCBL was observed in 32.5% of implants. A higher prevalence of surgical complications and implant failure was observed among patients who reported a penicillin allergy compared with those without a reported allergy (p < 0.05). Implants prescribed azithromycin showed a higher prevalence of surgical complications, and those prescribed azithromycin or clindamycin had higher early failure rates compared with penicillin (p < 0.05). Regression analyzes showed that self-reported penicillin allergy was not independently associated with surgical complications, PLCBL, or early implant failure (p > 0.05). In exploratory multivariable analyzes, azithromycin and other alternative antibiotics were associated with higher odds of surgical complications compared with penicillin (p < 0.05). No significant associations were found between antibiotic type and PLCBL or early implant failure (p > 0.05).

Self-reported penicillin allergy was not independently associated with early implant outcomes in this cohort. Certain alternative antibiotics were associated with a higher prevalence of early surgical complications, warranting further investigation in larger studies.