Clinical Relevance of Antibiotic Prophylaxis in Dental Surgical Procedures: A Systematic Review

Abstract

Background: Antibiotic prophylaxis is a procedure performed with the use of antibiotics to prevent the patient from contracting some type of infection during surgical procedures. Aim: To analyze the clinical relevance of using antibiotic prophylaxis before dental surgical procedures. Methods: This is a systematic review of the qualitative literature in the PubMed, LILACS and Medline databases, using the health descriptors "Antibiotic Prophylaxis", "Dentistry" and "Oral Surgical Procedures" and selected articles in English and Portuguese published between 2018 and 2022. Articles that did not follow the eligibility criteria and that did not address relevant data for the present study were excluded. Abstracts were also excluded; duplicate articles; review articles; meta-analysis and studies not related to dentistry. Results: After the research, considering the inclusion and exclusion criteria and thematic relevance, 15 articles were selected. Upon analysis, it was found that the effect of antibiotic prophylaxis in case of dental surgeries is small and may not be clinically relevant. Some improvement in postoperative symptoms in dental surgeries can be explained by the decrease in bacterial contamination of the surgical wound, and antibiotic prophylaxis is associated with a lower need for analgesic administration. Amoxicillin is considered the antibiotic of choice for antibiotic prophylaxis in clinical dental practice. In cases of penicillin allergy, clindamycin is often prescribed as a substitute of choice, with lower doses of clindamycin when given over shorter periods of time beneficial in relieving pain and reducing postoperative complications. Conclusion: Regarding the analyzed studies, it appears that the effect of antibiotic prophylaxis in cases of dental surgery may be small and not clinically relevant. In view of this, more studies on the clinical relevance of antibiotic prophylaxis in dental procedures should be carried out and more factors should be addressed in research to increase the scope of analysis.