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Antimicrobial Agents and Chemotherapy, September 2006, p. 2996-3002, Vol. 50, No. 9
0066-4804/06/$08.00+0     doi:10.1128/AAC.01550-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Comparative Efficacies of Amoxicillin, Clindamycin, and Moxifloxacin in Prevention of Bacteremia following Dental Extractions

P. Diz Dios,1* I. Tomás Carmona,1 J. Limeres Posse,1 J. Medina Henríquez,2 J. Fernández Feijoo,1 and M. Álvarez Fernández3

Department of Special Needs, School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain,1 Department of Anaesthesiology, Santiago de Compostela University Hospital, Santiago de Compostela, Spain,2 Research Laboratory, Department of Clinical Microbiology, Xeral-Cíes Hospital, Vigo, Spain3

Received 5 December 2005/ Returned for modification 14 February 2006/ Accepted 9 June 2006

We evaluated the efficacies of oral prophylactic treatment with amoxicillin (AMX), clindamycin (CLI), and moxifloxacin (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, 1 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 1 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.

* Corresponding author. Mailing address: Department of Special Needs, School of Medicine and Dentistry, Santiago de Compostela University, C./ Entrerrios s/n, Santiago de Compostela 15872, Spain. Phone: 34 981 563100, ext. 12344. Fax: 34 981 562226. E-mail: pdiz{at}usc.es.

Antimicrobial Agents and Chemotherapy, September 2006, p. 2996-3002, Vol. 50, No. 9
0066-4804/06/$08.00+0     doi:10.1128/AAC.01550-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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