Immune Activation after Apicoectomy: Comparison between Patients with and without Prophylactic Antibiotic Therapy

Summary In humans neopterin concentrations represent a sensItive index of cell-mediated immune activation. In a previous study, we found significantly increasing neopterin concentrations in patients after dental extractions. In this study, we investigated whether prophylactic antibiotic treatment of patients influenced the course of neopterin levels in patients with apicoectomy. Urinary neopterin concentrations were monitored in 23 patients with apicoectomy in the front region. Urine samples were collected before and on days 1, 3, 5, 7, 9 after apicoectomy. Six patients received antibiotic therapy, 17 were without such treatment. We found that average neopterin concentrations increased preferentially in patients not treated with antibiotics whereas pateints treated with antibiotics showed only a moderate increase of neopterin levels which returned to normal within three days. We conclude that antibiotic treatment is able to reduce immune activation which is frequently seen in patients after apicoectomy, and we assume this maybe also true in patients after dental extractions. Most likely transient bacteraemia is the cause of immune activation in such patients. However, an inhibitory influence of antibiotics on cytokine cascades cannot be ruled out.