Effect of Amoxicillin with Clavulanic Acid Antibiotic Premedication on Pre-Treatment and Post-Endodontic Pain in Teeth with Irreversible Pulpitis: A Randomized. Controlled Trial

Abstract

The purpose of this randomized, double-blind, controlled study was to assess the effect of antibiotic premedication on pre treatment and post opertive pain after endodontic treatment. Forty two patients with symptomatic irreversible pulpitis were randomized and allocated to experimental and placebo groups where the experimental group received the antibiotic premedication. Degree of pain was measured by the number of analgesics needed in addition to a four step pain scale before initiation of endodontic treatment and at time intervals of 6, 12, 24, 48 and 96 hours. We found that no statistical significant difference was detected at the pretreatment time interval. Statistical significant difference was groups after 24 hours of endodontic treatment where the experimental group reported less degree of post operative pain than the placebo group. No statistical significance difference detected at other time intervals. we concluded that antibiotic premedication could be prescribed to lessen the degree of post operative. pain after endodontic treatment

Evaluation of post-obturation pain in single-visit endodontic treatment after pre-medication with oral anti-inflammatory and antibiotics. An in-vivo study

“…Abielhassan et al (9) established that amoxicillin with clavulanic acid pre-medication could be prescribed to lessen the degree of post-operative pain after endodontic treatment. Ramazani et al (25) assessed post-operative pain after endodontic treatment of molar teeth with irreversible pulpitis and noticed that pre-medication with ibuprofen caused significantly greater pain reduction compared to zintoma and placebo at point of time.…”

“…Hence, individual use of antibiotic as a pre-medication has less effect on post-obturation pain. Abielhassan et al (9) concluded that amoxicillin with clavulanic acid antibiotic pre-medication could be prescribed to lessen the degree of post-operative pain after endodontic treatment. On the contrary, Pickenopaugh et al (14) determined the effect of amoxicillin on endodontic flare-up in asymptomatic necrotic teeth and concluded that prophylactic amoxicillin had no effect on the occurrence of flare-up.…”

“…It is readily absorbed, resists damage from stomach acids, and has a much broader spectrum against gram-negative bacteria compared to penicillin, but amoxicillin is susceptible to degradation by β-lactamase producing bacteria, so its use is recommended with clavulanic acid. It is a broad-spectrum antibiotic (9).…”