***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: The most common complications after surgical extraction of the third m and ibular molar are trismus , oedema or swelling , local pain , dysphagia and infection . The aim of this comparative , double-blind , r and omized clinical trial was to evaluate the efficacy of two sustained release amoxicillin/clavulanate regimens in the reduction of infection after third molar extractive surgery . A total of 225 patients were r and omized into three equal groups : placebo , prophylaxis with single pre-surgical dose of two tablets amoxicillin/clavulanate 1000/62.5 mg , and pre-emptive post-surgery therapy with two tablets amoxicillin/clavulanate 1000/62.5 mg BID for 5 days . A higher rate of infection ( P=0.006 ) was found among patients receiving placebo ( 16 % ) than those receiving single-dose prophylaxis ( 5.3 % ) or 5-day pre-emptive therapy ( 2.7 % ) . A relationship between both the duration ( 13.8 % for long versus 7.4 % for medium versus 1.6 % for short ) and difficulty ( 12.7 % with ostectomy versus 3.5 % without ostectomy ; P=0.011 ) of surgical procedure and incidence of subsequent infection was also observed . Both prophylactic and therapeutic regimens versus placebo achieved greater reduction of pain after surgery on day 3 ( P=0.001 ) . Logistic regression analysis revealed a risk of infection of 24 % , 9 % and 4 % for ostectomy with placebo , prophylaxis and pre-emptive treatment , respectively , whereas it was 7 % , 2 % and 1 % if ostectomy was not performed . Pre-emptive therapy with the oral sustained release amoxicillin/clavulanate formulation reduced the rate of subsequent infection in patients undergoing ostectomy . Prophylaxis was beneficial in simpler procedures and may be indicated in cases where ostectomy is not performed Background The aim of this study was to assess the efficacy of a single prophylactic dose of amoxicillin and /or dexamethasone in preventing postoperative complications ( PC ) after a surgical removal of a single m and ibular third molar ( M3 ) . Methods This study is a r and omized , placebo controlled clinical trial . Four groups were included : Group 1 ( G1 ) included a prophylactic dose of 2 g of amoxicillin and 8 mg of dexamethasone ; Group 2 ( G2 ) included a prophylactic dose of 2 g of amoxicillin and 8 mg of placebo ; Group 3 ( G3 ) included a prophylactic dose of 8 mg of dexamethasone and 2 g of placebo and ; Group 4 ( G4 ) placebo . Results Fifty patients were included . It was observed one case of alveolar infection ( 2 % ) and two of alveolar osteitis ( 4 % ) result ing in three PC ( 6 % ) . No statistical differences were observed between therapeutic groups for development of PC , trismus , pain and edema . The use of antibiotics showed an absolute risk reduction ( ARR ) for PC development of 3.52 % and the number needed to treat ( NNT ) was 29 . Conclusion Prophylactic antibiotics and corticoid in a single dose regimen did not bring any benefit on M3 surgeries OBJECTIVE The purpose of this study was to determine the effect of amoxicillin/clavulanic acid to prevent infection following completely bone-impacted lower third molar removal . STUDY DESIGN A r and om , double-blind placebo-controlled clinical trial including 118 adults r and omly allocated to placebo ( 60 patients ) or antibiotic treatment ( 58 patients ): 2 g amoxicillin/125 mg clavulanic acid 2 hours before the surgery and post-operatively twice a day for 4 days . Infection was clinical ly assessed until 8 weeks after surgery . Adverse events , as well as clinical and surgical variables , were recorded . Analysis was by intention to treat . RESULTS Infections developed in five patients in the placebo group , all in the first postoperative week , and in two in the antibiotic group , both after the first week , the difference not being statistically significant ( P = .278 , number needed to treat 19 [ 8-∞ ] ) . There were no relationships between any variables studied and infection . No serious adverse events were reported . CONCLUSION There is insufficient evidence to recommend routine use of this antibiotic treatment Aims and Objectives : To evaluate the role of prophylactic antibiotics , if any , in the removal of m and ibular impacted third molars . Patients and Methods : A total of 89 patients were r and omly allocated in 3 groups ( group 1 , placebo ; group 2 , amoxicillin 1 g orally 1 h before surgery ; and group 3 , metronidazole 800 mg orally 1 h before surgery ) . Results : Of the 89 patients , 5 had surgical wound infection ( 3 [ 10.33 % ] in group 1 , 2 [ 6.45 % ] in group 2 , and none [ 0 % ] in group 3 ) , leading to an overall infection rate of 5.61 % . There was no statistically significant difference found in surgical wound infection between the groups . Conclusions : Our study failed to show any advantage in the routine use of prophylactic antibiotics because we found no statistically significant difference between the groups Introduction : Antibiotic resistance is now a serious problem , although it was not so only a few years ago . The need of the hour is to give clear evidence of the efficacy of antibiotic use , or lack thereof , to the surgeon for a procedure as common as m and ibular third molar surgery . Aim : This study aim ed to evaluate whether postoperative combined amoxicillin and clavulanic acid in m and ibular third molar extraction is effective in preventing inflammatory complications . Study and Design : The study was structured as a prospect i ve r and omized double-blind placebo-controlled clinical trial . Material s and Methods : A study was design ed wherein the 96 units ( two bilaterally similar impacted m and ibular third molars per head in 48 patients ) were r and omly assigned to two treatment groups ( Group I and Group II ) . Each patient served as his/her own control . Each patient received 625 mg of combined amoxicillin and clavulanic acid 1 h before surgery . In the case of third molars belonging to Group I , 625 mg of combined amoxicillin and clavulanic acid TDS was continued for 3 days ; in Group II , placebo in similar-looking packs was continued for 3 days . The patients were evaluated on the third and seventh postoperative days for signs of clinical infection and for microbial load evaluation . Statistical Analysis : The data between the two groups were statistically analyzed by the two-tailed Fisher′s exact test , with a 95 % confidence interval . Results : The difference was not statistically significant between the test group and the control group with regard to erythema , dehiscence , swelling , pain , trismus , and infection based on microbial load . The data were statistically significant for alveolar osteitis , with the occurrence of alveolar osteitis ( 14.58 % ) in the placebo group . Conclusion : Postoperative antibiotics are recommended only for patients undergoing contaminated , long- duration surgery The use of prophylactic antibiotics to reduce postoperative complications in third molar surgery remains controversial . The study was a prospect i ve , r and omized , double blind , placebo-controlled clinical trial . 100 patients were r and omly assigned to two groups . Each patient acted as their own control using the split-mouth technique . Two unilateral impacted third molars were removed under antibiotic cover and the other two were removed without antibiotic cover . The first group received antibiotics on the first surgical visit . On the second surgical visit ( after 3 weeks ) , placebo capsules were given or vice versa . The second group received antibiotics with continued therapy for 2 days on the first surgical visit and on the second surgical visit ( after 3 weeks ) placebo capsules were given or vice versa . Pain , swelling , infection , trismus and temperature were recorded on days 3 , 7 and 14 after surgery . Of 380 impactions , 6 sockets ( 2 % ) became infected . There was no statistically significant difference in the infection rate , pain , swelling , trismus , and temperature between the two groups ( p>0.05 ) . Results of the study showed that prophylactic antibiotics did not have a statistically significant effect on postoperative infections in third molar surgery and should not be routinely administered when third molars are removed in non-immunocompromised patients Postoperative infections in the oral region are usually caused by anaerobic bacteria . While some authors cl aim that routine antibiotic prophylaxis is necessary after third molar surgery , others do not recommend this practice . The major subject of controversy is what constitutes postoperative infection . Previous studies that have examined the benefit of routine antibiotic prophylaxis have used several clinical symptoms ( pain , swelling , and trismus ) as indicators of infection ; however , these clinical symptoms may be vague and unreliable , and can not be evaluated scientifically . As a result , their use has only sparked more debate in this area of research . The present study assessed the value of routine antibiotic prophylaxis in impacted m and ibular third molar surgery using acute-phase protein levels as potential indicators of early and late postoperative infection . Specifically , serum levels of C-reactive protein and alpha-1 antitrypsin were measured preoperatively and postoperatively in patients who received either prophylactic antibiotics or placebos . The results revealed no statistically significant difference between treated and control patients in terms of incidence of postoperative infection Introduction Antimicrobial resistance is a growing problem that is likely to have a major negative impact on healthcare in the future . Dentists have a key role in ensuring that antimicrobials are prescribed correctly to reduce the emergence of resistant strains . Objective To audit how appropriately antimicrobials were prescribed in the oral surgery acute dental department of Guy 's Hospital in London , when compared to the st and ards set within the Faculty of General Dental Practice (UK)1 and Scottish Dental Clinical Effectiveness2 guidelines on antimicrobial prescribing in dentistry . Target 100 % compliance . Method A prospect i ve audit consisting of two cycles ( each including 60 patients ) was carried out . Between each cycle , there was a two-month intervention period , which included extensive training and education of staff and students . Results Cycle 1 showed that only 30 % of prescriptions were appropriate and only 62 % of practitioners were recording a diagnosis . After two months of intervention , cycle 2 was carried out ; this showed a significant improvement , with 80 % of prescriptions being appropriate and 100 % of practitioners recording a diagnosis . The majority of inappropriate prescriptions in both cycles were for acute pulpitis without evidence of systemic involvement . Conclusion This audit has shown that clinical practice for antimicrobial prescribing did not follow the published guidelines . Following targeted interventions , a substantial improvement was made in the prescribing pattern . The target of 100 % has not been reached , necessitating further intervention OBJECTIVE To find out whether the frequency of postoperative infectious and inflammatory complications ( IC ) in subjects treated with placebo ( Pl ) is greater than those treated with antibiotic ( Ab ) after extraction of an impacted m and ibular third molar ( M3 ) . Our hypothesis is there are more IC in Pl than in Ab , with a maximum ratio difference of 0.067 . STUDY DESIGN A double-blind placebo-controlled r and omized clinical trial . The sample was derived from the population of subjects attending Cruces Hospital for evaluation and extraction of 1 M3 under local anesthesia . Patients were treated with postoperative placebo or amoxicillin/clavulanic acid 500/125 mg 3 times a day during 4 days . The outcome variable was infectious and inflammatory complications . Sex , age , smoking , molar depth , angulation , need for sectioning , ostectomy , and operation time were recorded . Analysis was by intention to treat , risk measures , and logistic regression . RESULTS In 490 subjects ( 259 Ab and 231 Pl ) , the frequency of IC was 1.9 % in the Ab and 12.9 % in the Pl group ( OR 7.6 , 95%CI 2.9 - 19.9 ; P < .001 ) . The number needed to treat was 10 ( 7 - 16 ) . Unadjusted relative risk was 0.15 ( 0.06 - 0.38 ) ( P < .001 ) . Absolute reduction risk was 0.11(0.066 - 0.155 ) ] . Therefore , the hypothesis can not be rejected . Multivariate analysis shows treatment with antibiotic ( OR = 8.66 ( 3.17 - 23.67 ) ; P < .001 ) and age ( OR = 1.08 ( 1.00 - 1.16 ) ; P = .029 ) are the only variables to be included in the logistic regression model . CONCLUSION Amoxicillin/clavulanic acid is efficacious in reducing the incidence of IC following third molar extraction but should not be prescribed in all cases PURPOSE The aim of the present study was to evaluate and compare the occurrence of postoperative complications in patients receiving either pre- or postoperative amoxicillin versus placebo after third molar surg 
    Output:
    
Prophylactic use of amoxicillin does not significantly reduce the risk of infection and /or dry socket after third molar extraction .
With amoxicillin/clavulanic acid , the risk decreases significantly .
Nevertheless , considering the number needed to treat , low prevalence of infection , potential adverse reactions to antibiotics and lack of serious complications in placebo groups , the routine prescription of amoxicillin with or without clavulanic acid is not justified