Effects of clindamycin and amoxycillin as prophylaxis against early implant failure: double-blinded randomized clinical trial

• Published in: Clinical oral investigations 2024-11, Vol.28 (12), p.643, Article 643
• Main Authors: Pradillo-Gallego, Diego, Manzano-Moreno, Francisco Javier, Ocaña-Peinado, Francisco Manuel, Olmedo-Gaya, Maria Victoria
• Format: Article
• Language: English
• Subjects: Adult; Aged; Amoxicillin; Amoxicillin - administration & dosage; Amoxicillin - therapeutic use; Anti-Bacterial Agents - administration & dosage; Antibiotic Prophylaxis - methods; Antibiotics; Clindamycin; Clindamycin - administration & dosage; Clindamycin - therapeutic use; Clinical outcomes; Clinical trials; Dental Implants; Dental Restoration Failure; Dentistry; Double-Blind Method; Female; Health risks; Humans; Infections; Inflammation; Male; Medicine; Middle Aged; Pain; Patients; Penicillin; Postoperative infection; Postoperative period; Prophylaxis; Side effects; Statistical analysis; Surgery; Surgical Wound Infection - prevention & control
• ISSN: 1436-3771; 1432-6981; 1436-3771
• DOI: 10.1007/s00784-024-06050-1

Objective The objective of this randomized controlled clinical trial (RCT) was to compare the frequency of early implant failure, postoperative infection, and pain/inflammation and the degree of implant stability between healthy non-penicillin-allergic individuals receiving a single prophylactic dose of 600 mg clindamycin versus 2 g amoxicillin at 1 h before implant surgery. Materials and methods A single-center double-blinded RCT study with parallel groups was undertaken. Eighty-two patients fulfilled study inclusion criteria and were randomly assigned to the amoxicillin ( n  = 41) or clindamycin ( n  = 41) group. The primary outcome variable was early implant failure. The presence of infection was evaluated immediately after surgery and on days 7, 14, 30, and 90, and postoperative pain/inflammation was assessed daily on days 1 to 7 post-surgery. Resonance frequency analysis was used to measure primary and secondary implant stability. Results One early implant failure was observed (1/81), in a patient from the amoxicillin group. No statistically significant between-group differences were observed in early implant failure rate, postoperative infection rate up to 90 days, pain/inflammation scores during the first week post-surgery, or primary or secondary stability values. Conclusions A single dose of 600 mg clindamycin before implant surgery does not increase the risk of early implant failure or infection. Clinical relevance These findings suggest that a single dose of 600 mg clindamycin at 1 h before implant surgery is a safe antibiotic prophylactic approach; however, when a more prolonged antibiotic therapy is required, it appears advisable to prescribe an alternative antibiotic to avoid adverse effects.