Prophylactic use of cephradine in dental procedures: A observational study in Bangladesh

Bacteremia is common with manipulation of the teeth and periodontal tissues during dental procedures. Majority of dental office visits result in some degree of bacteremia that warrants antibiotic prophylaxis before a dental procedure to reduce the frequency, nature or duration of bacteremia. This study aimed to collect data on prophylactic use of cephradine which is most preferred in dental procedures in Bangladesh.  A total 2219 of patients both adult and children above 5 years were enrolled to assess use of antibiotic, its dose and duration for antibiotic prophylaxis during dental procedures. Efficacy of antibiotic prophylaxis in terms of clinical cure, further dose modification and need to change antibiotic was evaluated at day 10 of antibiotic use and in case of root canal therapy at day 30. Any side effect of antibiotic use recorded within 3 days was considered for safety evaluation. This was a non-controlled, multicentre, observational study. 2016 (90.9%) of the patients received cephradine as prophylactic antibiotic with a mean dosage of 500mg (487.48+60.99) and duration of treatment was 3-7 days (5.47+1.03). Some of the dentists also preferred amoxicillin (149, 6.7%) and cephalexin (54, 2.4%) for prophylaxis. The majority of the patients (1657, 82.2%) who had prophylaxis with cephradine had no clinical sign of infection and some of the patients needed to change their initial dose or change of the antibiotic. Overall 1816 (81.8%) patients were found having no clinical sign of infection on antibiotic prophylaxis. Among the patients 239 (10.7%) needed to change the dose of prescribed antibiotic and 55 (2.4%) were required to change their prescribed antibiotic. However, the data on type of infection was not recorded. 109 (4.9%) patients were lost to follow up on Day 10. Prescribed antibiotic prophylaxis was not associated with adverse events in majority (91%) of the patients. Some of the patients reported diarrhea (104, 4.7%), stomach upset (68, 3.1%) and dizziness (31, 1.4%) during antibiotic use. However, those were self-limiting and no dose adjustment, discontinuation of therapy or withdrawal from the study was required. No serious adverse events were reported. Cephradine 500 mg for 5 days course was preferred as prophylactic antibiotic in dental procedures in this study. Majority of the patients had no clinical sign of infection on evaluation at day 10. Cephradine therapy was mostly not associated with adverse events in patients; however, diarrhea, stomach upset and dizziness were reported in some patients that were self-limiting.Bangladesh Journal of Dental Research and Education Vol.5(2) 2015: 49-54