Penicillin as a supplement in resolving the localized acute apical abscess

Fouad, Ashraf F.; Rivera, Eric M.; Walton, Richard E.

doi:10.1016/s1079-2104(96)80054-0

Cited by 100 publications

(90 citation statements)

References 21 publications

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“…This was despite the dentists having been given relevant literature to the contrary to read, supplemental to the educational component of the study. [19][20][21][22][23][24][25][26][27][28][29] As a consequence, it is suggested that should this study be replicated elsewhere, a third cycle in the audit spiral could be considered, so that after the second meeting of the dentists, where the improved results would be discussed and education reinforced, there would then be another opportunity for anonymous scrutiny and peer review to achieve even further improvement.…”

Section: Discussionmentioning

confidence: 99%

The impact of clinical audit on antibiotic prescribing in general dental practice

Chate¹,

White

Hale

et al. 2006

Br Dent J

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• Describes an audit undertaken in the East of England on antibiotic prescribing in general dental practice.• The protocols of an original North West of England audit published in 2001 were deliberately replicated, in order to be able to pool the data and obtain a sample size of at least 1% of all UK dentists.• The combined Regional results confi rm that clinical audit reduces both the number of errors made by dental practitioners when writing out a prescription, as well as the number of those which are issued inappropriately, as compared to contemporary prescribing guidelines. I N B R I E FThe impact of clinical audit on antibiotic prescribing in general dental practice Objective To reduce the number of antibiotics inappropriately prescribed by general dental practitioners, and to increase overall prescription accuracy. Design A prospective clinical audit carried out between September and March of 2002-3 and 2003-4. Setting General dental practices in Eastern England. Subjects and methods The pre-audit antibiotic prescribing practices of 212 general dental practitioners were recorded over an initial six week period. On each occasion this included which antibiotic had been chosen, together with its dose, frequency and duration, as well as the clinical condition and reason for which the prescription had been raised. When related to prophylaxis, the patient's medical history was also noted. Following education on contemporary prescribing guidelines, presentations which illustrated the practitioners' previous errors, and the agreement of standards to be achieved, the process was repeated for another six weeks, and the results compared. Results In the pre-audit period, 2,951 antibiotic prescriptions were issued, and during the audit this was reduced by 43.6% to 1,665. The majority were for therapeutic reasons, with only 10.5% and 13.6% for medical prophylaxis during the pre-audit and audit periods respectively. Over both periods, amoxicillin and metronidazole were the two most commonly prescribed antimicrobials (63.4% and 21.2% respectively). In the pre-audit period, only 43% of all prescriptions were error free in dose, frequency, and/or duration of use, but this rose signifi cantly to 78% during the audit. Equally, using contemporary published guidelines, out of all the prescriptions made in the pre-audit period, only 29.2% were deemed to be justifi ed, as compared to 48.5% during the audit. Conclusions Clinical audit, in conjunction with education, and prescribing guidelines can favourably change antibiotic prescribing patterns among general dental practitioners.

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Section: Discussionmentioning

confidence: 99%

The impact of clinical audit on antibiotic prescribing in general dental practice

Chate¹,

White

Hale

et al. 2006

Br Dent J

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“…In some cases, drainage can be obtained through the root canal, but when swelling is present, incision for drainage should also be performed whenever possible, since this approach has been shown to produce a quicker improvement than drainage only by opening of the root canal (200). Adjunctive systemic antibiotics are not necessary in most cases of localized and uncomplicated apical abscesses (201)(202)(203)(204)(205). Analgesics may be prescribed for pain control.…”

Section: Treatment Of the Acute Apical Abscessmentioning

confidence: 99%

Microbiology and Treatment of Acute Apical Abscesses

2013

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SUMMARY Acute apical abscess is the most common form of dental abscess and is caused by infection of the root canal of the tooth. It is usually localized intraorally, but in some cases the apical abscess may spread and result in severe complications or even mortality. The reasons why dental root canal infections can become symptomatic and evolve to severe spreading and sometimes life-threatening abscesses remain elusive. Studies using culture and advanced molecular microbiology methods for microbial identification in apical abscesses have demonstrated a multispecies community conspicuously dominated by anaerobic bacteria. Species/phylotypes commonly found in these infections belong to the genera Fusobacterium , Parvimonas , Prevotella , Porphyromonas , Dialister , Streptococcus , and Treponema . Advances in DNA sequencing technologies and computational biology have substantially enhanced the knowledge of the microbiota associated with acute apical abscesses and shed some light on the etiopathogeny of this disease. Species richness and abundance and the resulting network of interactions among community members may affect the collective pathogenicity and contribute to the development of acute infections. Disease modifiers, including transient or permanent host-related factors, may also influence the development and severity of acute abscesses. This review focuses on the current evidence about the etiology and treatment of acute apical abscesses and how the process is influenced by host-related factors and proposes future directions in research, diagnosis, and therapeutic approaches to deal with this disease.

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“…Many studies are inadequately blinded and have not adequately controlled inclusion criteria. This has resulted in patients receiving multiple surgical and medical interventions making it impossible to analyse the relative contributions of each intervention to the success of treatment (Adriaenssen, 1998;Davis & Balcom, 1969;Fazakerley et al, 1993;Fouad et al, 1996;Gilmore et al, 1988;Hanna, 1991;Kuriyama et al, 2005;Lewis et al, 1986Lewis et al, , 1993Mangundjaja & Hardjawinata, 1990). In one study, a total of six antibiotic regimens were prescribed with patients also receiving either incision and drainage or drainage through the tooth (Kuriyama et al, 2005).…”

Section: Treatment Of the Acute Dental Abscessmentioning

confidence: 99%

“…Other difficulties include a lack of standardization in how the primary outcome is measured, with some studies relying on clinical assessment of relatively crude measures, i.e. failure, slight improvement, cure (Adriaenssen, 1998;Gilmore et al, 1988;Hanna, 1991;Kuriyama et al, 2005), and others a combination of both patient responses and clinical examination with welldefined but subjective criteria (Fazakerley et al, 1993;Fouad et al, 1996;Mangundjaja & Hardjawinata, 1990;Paterson & Curzon, 1993;Schuen et al, 1974;von Konow et al, 1992).…”

Section: Treatment Of the Acute Dental Abscessmentioning

confidence: 99%

The microbiology of the acute dental abscess

Robertson

Smith

2009

Journal of Medical Microbiology

193

136

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The acute dental abscess is frequently underestimated in terms of its morbidity and mortality. The risk of potential serious consequences arising from the spread of a dental abscess is still relevant today with many hospital admissions for dental sepsis. The acute dental abscess is usually polymicrobial comprising facultative anaerobes, such as viridans group streptococci and the Streptococcus anginosus group, with predominantly strict anaerobes, such as anaerobic cocci, Prevotella and Fusobacterium species. The use of non-culture techniques has expanded our insight into the microbial diversity of the causative agents, identifying such organisms as Treponema species and anaerobic Gram-positive rods such as Bulleidia extructa, Cryptobacterium curtum and Mogibacterium timidum. Despite some reports of increasing antimicrobial resistance in isolates from acute dental infection, the vast majority of localized dental abscesses respond to surgical treatment, with antimicrobials limited to spreading and severe infections. The microbiology and treatment of the acute localized abscess and severe spreading odontogenic infections are reviewed.

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Penicillin as a supplement in resolving the localized acute apical abscess

Cited by 100 publications

References 21 publications

The impact of clinical audit on antibiotic prescribing in general dental practice

The impact of clinical audit on antibiotic prescribing in general dental practice

Microbiology and Treatment of Acute Apical Abscesses

The microbiology of the acute dental abscess

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