As antibiotic resistance is gradually becoming global threat with rapid emergence of drug resistance organisms, there is an urgent need to limit the use of antibiotics to "selected cases". But unfortunately there is no standard definition available for this term "Selected cases". This still remains a grey area in dental practice. Though many countries/hospitals have a standard prescription protocols, it still lacks uniformity.
In Germany we have no standard, but a recommendation for the use of antibiotics in dental practice:
http://www.dgzmk.de/uploads/tx_szdgzmkdocuments/20020701-Antibiotika_in_der_Zahnaerztlichen_Praxis.pdf?PHPSESSID=a214add3afb12cfcd75a452deadc91b2
Even this is not in english, I hope it will help you!
Kind regards,
Rudolf Ritt
There are no such standard protocols for prescribing antibiotics and analgesics, even though guidelines do exist with some variability.
In clinical practice the use of antibiotics is guided by empiric use, unfortunately there are a misuse of antibiotics stimulated by pharmaceutical labs and dentist's fears.
The use of antibiotics must answer these questions:
1- is necessary?
Patient, physical or health condition, clinical procedure, diagnosis
2. Which antibiotic?
against anaerobic and aerobic bacteria
3. what dose?
4. What duration?
5. can it induce side effects?
Palmer NO. Antibiotic prescribing in general dental practice.Prim Dent J. 2014 Feb;3(1):52-7.
Rochlen GK, Keenan AV. Value of prophylactic antibiotics for invasive dental procedures unclear. Evid Based Dent. 2014 Mar;15(1):12-3
The FGDP(UK) have produced such a document.
It is available on their website:
http://www.fgdp.org.uk/publications/antimicrobial-prescribing-standards.ashx
Regards,
Paul
Thank you Paul, but to log in to FGDP one should be a member. It will be kind of you if you can share the particular document.
Apologies with the delay. Try the link to the main site (http://www.fgdp.org.uk) and then click on the open standards tab. The username and password is at the bottom of the page and is 'open standards'.
Basic principles of antimicrobial terpêutica:
Clinical Diagnosis
etiologic diagnosis
Sensitivity Test (Antibiogram)
Patient's clinical condition.
My clinical experience is to use high doses when have decided to use antibiotics to reduce the development of resistant bacteria. You want to wipe out the bacteria fast. Use the big guns. Also pre-op use of antibiotics should be used if even there is a chance of post-op infection. Treating post-op infections with antibiotics must to be avoided.
A useful reference / guideline are the Therapeutic Guidelines series .. nominally most relevant to Australia but the general principles are applicable universally. There are 14 books in the series as well as an online version. There is one covering Oral / Dental/
See http://www.tg.org.au/index.php?sectionid=130