This is a summary of the article: "Antibiotics for the urgent management of symptomatic irreversible pulpitis, symptomatic apical periodontitis, and localized acute apical abscess. Systematic review and meta-analysisda report of the American Dental Association" in the December 2019 edition of the Journal of the American Dental Association.
Patients with pulpal and periapical conditions often seek treatment for pain, intraoral swelling, or both. Even when definitive, conservative dental treatment (DCDT) is an option, antibiotics are often prescribed. The purpose of this review was to summarize available evidence regarding the effect of antibiotics, either alone or as adjuncts to DCDT, to treat immuno-competent adults with pulpal and periapical conditions, as well as additional population-level harms associated with antibiotic use.
Clinical Implications
Evidence for antibiotics, either alone or as adjuncts to definitive, conservative dental treatment, showed both a benefit and a harm for outcomes of pain and intraoral swelling and a large potential magnitude of effect in regard to additional harm outcomes. The impact of dental antibiotic prescribing requires further research.
Evidence also suggests large potential harms associated with antibiotic use for any condition for the outcomes of community-associated Clostridioides difficile infection (CDI), mortality due to community-associated Clostridioides difficile infection (CDI), antibiotic-resistant infections, and mortality due to antibiotic-resistant infections.
Clinical decision making should include this summary of benefits and harms along with other pertinent considerations, including the patient’s values and preferences, acceptability, and feasibility.
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Until next time!
Chiraz Guessaier, CDA Oasis Manager
Thanks! Good info for use.