Elsevier

Dental Abstracts

Volume 61, Issue 5, September–October 2016, Pages 259-260
Dental Abstracts

Hands On
Antibiotic use

https://doi.org/10.1016/j.denabs.2016.05.023Get rights and content

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Background

The genetic changes that create drug-resistant microbes have been linked to the excessive prescription of antibiotics by health care providers over the past decades. As a result, guidelines are being developed to indicate when antibiotics should and should not be prescribed for patients. These are evidence-based, relying mainly on randomized controlled clinical studies. The indications for prescribing antibiotics for patients with endodontic infections to reduce pain were formulated from a

Methods

An electronic search was conducted of the MEDLINE, Scopus, Cochrane Library, and ClinicalTrials.gov databases, along with a hand search of the bibliographies of relevant articles, gray literature, and textbooks. The review of articles focused on two primary clinical situations: the administration of antibiotics preoperatively and the administration of antibiotics postoperatively to prevent pulpal and periapical pain or exacerbations after endodontic treatment.

Results

Giving antibiotics preoperatively to prevent pain or an endodontic flare-up was evaluated in two studies. The authors found that preoperative antibiotic administration was ineffective in alleviating pain in pulpal tissue or periapical tissue. One study of patients with irreversible pulpitis used amoxicillin 1 hour before endodontic treatment. The other studied patients with untreated symptomatic irreversible pulpitis and used a preoperative 7-day course of oral penicillin V potassium, 4 times a

Discussion

Based on the currently available evidence, antibiotics should not be prescribed preoperatively or postoperatively for patients with irreversible pulpitis if the goal is to prevent infection and pain.

Clinical Significance

Using systemic antibiotics is not indicated for the reduction of pain or infection in patients having endodontic treatment. With a proper diagnosis and careful endodontic treatment, the number of infectious organisms will be effectively reduced and healing will be able to

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Aminoshariae A, Kulild JC: Evidence-based recommendations for antibiotic usage to treat endodontic infections and pain: A systematic review of randomized controlled trials. J Am Dent Assoc 147:186-191, 2016

Reprints available from A Aminoshariae, Undergraduate Endodontics, School of Dental Medicine, Case Western Reserve Univ, 2123 Abington Rd, A280, Cleveland, OH 44106; [email protected]

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