Randomized Study of Surgical Prophylaxis in Immunocompromised Hosts.
Lopes DR, Peres MP, et al.Journal of Dental Research, 90(2): 225-9, 2011.
Aims
To compare two regimens of antimicrobial prophylaxis for preventing surgical site infections of an invasive dental procedure in immunosuppressed patients with cancer or solid organ transplant.
Interventions
Amoxicillin 500 mg administered orally 2 hours before the invasive dental procedure versus amoxicillin 500 mg administered orally 2 hours before the procedure and a second dose 8 hours later.
Participants
414 patients who had a kidney, kidney-pancreas, or liver transplant or had chemotherapy for cancer.
Outcomes
The primary outcomes were incisional surgical site infection and organ/space surgical site infection. The secondary outcomes included use of medication for pain, systemic use of an antimicrobial drug, hospitalization and death rate.
Follow-up
4 weeks
CET Conclusions
This well designed study of amoxicillin prophylaxis before an invasive dental procedure in 414 patients with either cancer or an organ transplant received either 500mg of amoxicillin 2 hours before the procedure or 500mg of amoxicillin 2 hours before the procedure and a second dose 8 hours later. Two thirds of the patients had had an organ transplant but there was no significant difference in outcomes depending on which dosage regimen of amoxicillin was used. The infection rate was low in both arms and as the sample size had been calculated based on an infection rate of 10% the study was underpowered.
Data analysis
Strict intention-to-treat analysis
Trial registration
Not reported