A comparative analysis of the efficacy of moxifloxacin and cefixime in reduction postoperative inflammatory sequelae after mandibular third molar surgery

Background/Aim. There is no scientific evidence that prophylactic use of antibiotics as a part of the mandibular third molar surgery is effective in suppressing postoperative pain, edema, trismus and dry socket. The aim of the present study was to investigate the effects of antibiotics from the fluoroquinolone (moxifloxacin) and cephalosporin (cefixime) groups, in reducing inflammatory postoperative sequelae (pain, edema and trismus), as well as in possibly reducing the incidence of dry socket after mandibular third molar surgery. Methods. This double-blind study was completed by 157 subjects, comprising two study groups (who received the aforementioned antibiotics), and a control group, who received placebo-tablets. Subjects were assessed on the first, second, and seventh day following surgery. In the postoperative course, patients were monitored for the occurrence, intensity and duration of postoperative inflammatory sequelae and dry socket. Results. Both antibiotics, especially moxifloxacin, had a pronounced effect on reducing all inflammatory sequelae (pain, edema and trismus) as the most common postoperative complaints following mandibular third molar surgery. It is interesting, however, that both antibiotics, especially moxifloxacin, also contributed to reducing the incidence of dry socket. Conclusion. Antibiotic prophylaxis with cefixime, and especially moxifloxacin, reduced the occurrence of postoperative inflammatory sequelae and alleviated discomfort, suggesting that this is a useful, rather than risky recommendation. It is interesting, however, that both antibiotics, especially moxifloxacin, also contributed inreducing the incidence of postoperative dry socket, which is not provoked by inflammation. Therefore, further research into the underlying mechanisms behind such an effect is warranted.