Comparative efficacies of amoxicillin, clindamycin, and moxifloxacin in prevention of bacteremia following dental extractions
Comparative efficacies of amoxicillin, clindamycin, and moxifloxacin in prevention of bacteremia following dental extractions
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DOI：
10.1128/aac.01550-05
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发表时间：
2006-09-01
影响因子：
4.9
通讯作者：
Fernandez, M. Alvarez
中科院分区：
文献类型：
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作者：
Dios, P. Diz;Carmona, I. Tomas;Fernandez, M. Alvarez
我们评价了口服阿莫西林(AMX)、克林霉素(CLI)和莫西沙星(MXF)预防拔牙术后菌血症的疗效。将221例需要在全身麻醉下拔牙的成人随机分为对照组、AMX组、CLI组和MXF组(药物处理组在麻醉诱导前1~2 h分别给予2g、600 mg和400 mg)。分别于拔牙前、拔牙后30min、15min、1h采集S静脉血。将标本接种到BACTEC Plus好氧和厌氧血培养瓶中，在BACTEC 9240仪器中进行处理。用常规微生物技术对分离的细菌进行传代培养和进一步鉴定。对照组、AMX组、CLI组和MXF组的BDE发生率在S 30分钟时分别为96%、46%、85%和57%，在15分钟时分别为11%、70%和24%，在链球菌感染时分别为20%、4%、22%和7%。是所有组中最常见的细菌(44%至68%)，AMX组检测到的百分比最低(44%)。AMX和MXF预防在降低BDE的患病率和病程方面效果显著，而CLI预防无效。因此，MXF预防是一种很有前途的抗生素替代方案，可用于预防β-内酰胺类药物不适用时的BDE。
We evaluated the efficacies of oral prophylactic treatment with amoxicillin (AMX), clindamycin (CLI), and moxiffoxacin (MXF) in the prevention of bacteremia following dental extractions (BDE). Two hundred twenty-one adults who required dental extractions under general anesthesia were randomly assigned to a control group, an AMX group, a CLI group, and an MXF group (the individuals in the drug treatment groups received 2 g, 600 mg, and 400 mg, respectively, I to 2 h before anesthesia induction). Venous blood samples were collected from each patient at the baseline and 30 s, 15 min, and 1 h after the dental extractions. The samples were inoculated into BACTEC Plus aerobic and anaerobic blood culture bottles and were processed in a BACTEC 9240 instrument. Subculture and the further identification of the isolated bacteria were performed by conventional microbiological techniques. The prevalences of BDE in the control group, AMX group, CLI group, and MXF group were 96, 46, 85, and 57%, respectively, at 30 s; 64, 11, 70, and 24%, respectively, at 15 min; and 20, 4, 22, and 7%, respectively, at I h. Streptococcus spp. were the most frequently identified bacteria in all groups (44 to 68%), with the lowest percentage being detected in the AMX group (44%). AMX and MXF prophylaxis showed high efficacies in reducing the prevalence and duration of BDE, but CLI prophylaxis was noneffective. As a consequence, MXF prophylaxis is a promising antibiotic alternative for the prevention of BDE when beta-lactams are not indicated.