The use and misuse of antibiotics in dentistry

Stein, Kelli; Farmer, Julie; Singhal, Sonica; Marra, Fawziah; Sutherland, Susan E.; Quiñonez, Carlos

doi:10.1016/j.adaj.2018.05.034

Cited by 101 publications

(109 citation statements)

References 108 publications

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“…Evidence suggests that 24 hours after starting antibiotics, pain intensity may increase slightly, but after followed by 250 mg for an additional 4 d) or oral clindamycin (300 mg, 4 times per d, 3-7 d). 24 Bacterial resistance rates for azithromycin are higher than for other antibiotics, and clindamycin substantially increases the risk of developing Clostridioides difficile infection even after a single dose. 25 Owing to concerns about antibiotic resistance, patients who receive azithromycin should be instructed to closely monitor their symptoms and call a dentist or primary care provider if their infection worsens while receiving therapy.…”

Section: Desirable and Undesirable Effects From Randomized Controlledmentioning

confidence: 99%

“…To inform the current status of antibiotic prescribing behaviors of dentists, including antibiotic types, doses, and durations, we used a 2018 scoping review. 24 We also included input from stakeholders and expert panelists and data on antibiotic sensitivity [54][55][56][57][58] to determine the most appropriate course of action when first-line treatment fails, guidance to avoid recommending antibiotics closely monitor their symptoms and call a dentist or primary care provider if their infection worsens while receiving therapy. Similarly, clindamycin has a US Food and Drug Administration black box warning for Clostridioides difficile infection, which can be fatal.…”

Section: Summary Of the Rationale For The Type Of Antibiotic And Regimenmentioning

confidence: 99%

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Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling

Lockhart¹,

Tampi²,

Abt³

et al. 2019

The Journal of the American Dental Association

123

106

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Background. An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated clinical recommendations for the urgent management of symptomatic irreversible pulpitis with or without symptomatic apical periodontitis, pulp necrosis and symptomatic apical periodontitis, or pulp necrosis and localized acute apical abscess using antibiotics, either alone or as adjuncts to definitive, conservative dental treatment (DCDT) in immunocompetent adults. Types of Studies Reviewed. The authors conducted a search of the literature in MEDLINE, Embase, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature to retrieve evidence on benefits and harms associated with antibiotic use. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and the Evidence-to-Decision framework. Results. The panel formulated 5 clinical recommendations and 2 good practice statements, each specific to the target conditions, for settings in which DCDT is and is not immediately available. With likely negligible benefits and potentially large harms, the panel recommended against using antibiotics in most clinical scenarios, irrespective of DCDT availability. They recommended antibiotics in patients with systemic involvement (for example, malaise or fever) due to the dental conditions or when the risk of experiencing progression to systemic involvement is high. Conclusion and Practical Implications. Evidence suggests that antibiotics for the target conditions may provide negligible benefits and probably contribute to large harms. The expert panel suggests that antibiotics for target conditions be used only when systemic involvement is present and that immediate DCDT should be prioritized in all cases.

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Section: Desirable and Undesirable Effects From Randomized Controlledmentioning

confidence: 99%

Section: Summary Of the Rationale For The Type Of Antibiotic And Regimenmentioning

confidence: 99%

Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling

Lockhart¹,

Tampi²,

Abt³

et al. 2019

The Journal of the American Dental Association

123

106

View full text Add to dashboard Cite

show abstract

“…It should also be noted that the risk of infection after simple tooth extraction (excluding third molars) in healthy and in medically compromised patients still needs to be fully evaluated. The use of prophylactic antibiotics is clearly indicated in cases of invasive procedures for those patients who had already suffered from an endocarditis or for those who are severely immunocompromised (Davies, 2010; Stein et al, 2018; WHO, 2014). In addition, the antibiotics should be administered in case of odontogenic and non‐odontogenic infections when a local treatment has already failed or when the patient's conditions do not allow the completion of an adequate local treatment (American Association of Endodontists, 2017; Coté & Wilson, 2016; Davies, 2010; Enzler, Berbari, & Osmon, 2011).…”

Section: Introductionmentioning

confidence: 99%

Antibiotic’s effectiveness after erupted tooth extractions: A retrospective study

et al. 2020

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Objective The purpose of this retrospective study was to assess the influence of antibiotics on the development of alveolitis after tooth extractions. Materials and Methods The study population consisted of patients who had erupted tooth extractions in 3 centers. The patients’ medical records were collected for several parameters. Moreover, use of antibiotics was evaluated. The primary outcome was the development of alveolitis during the postoperative period. The secondary outcome measure was the possible associations between alveolitis and other patients’ characteristics. Results A total of 1579 patient charts were screened. The patients enrolled in the study were 418 (159 males and 259 females). Alveolitis was reported for 12 extraction sites (2.87%). Six were in the group of patients that received antibiotics (2.14% out of 280 patients treated with antibiotics), and six were in the group of patients that did not receive antibiotics (4.35% out of 138 patients not receiving antibiotics). None of patient‐level parameters showed any significant association with the development of alveolitis. Conclusion In conclusion, this study showed that the use of antibiotics after erupted tooth extractions is not useful in preventing alveolitis. Larger, prospective, and randomized studies are needed before incorporating these findings into the daily clinical practice.

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“…3 Many studies have evaluated the prescription trend of dental antibiotics worldwide. [4][5][6][7][8][9] For instance, in the USA, it was found that dental practitioners and dentists prescribed more than 2.9 million antibiotics per year. 5 Moreover, a retrospective study in Croatia showed that antibiotics were prescribed during almost half of the dental emergency visits.…”

Section: Introductionmentioning

confidence: 99%

<p>Inappropriate Dental Antibiotic Prescriptions: Potential Driver of the Antimicrobial Resistance in Albaha Region, Saudi Arabia</p>

Robinson¹,

Alzahrani²,

Aldannish³

et al. 2020

RMHP

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The use and misuse of antibiotics in dentistry

Cited by 101 publications

References 108 publications

Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling

Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling

Antibiotic’s effectiveness after erupted tooth extractions: A retrospective study

<p>Inappropriate Dental Antibiotic Prescriptions: Potential Driver of the Antimicrobial Resistance in Albaha Region, Saudi Arabia</p>

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