Antibiotic Considerations in Oral Surgery
In the latest installment in a series of presentations on the principles of oral surgery for general practitioners, Dr. Keyvan Abbaszadeh, an oral and maxillofacial surgeon from London, Ontario, reviews the use of antibiotics in oral surgery.
Here are some key takeaways from the conversation:
- 94% of oral infections are caused by anaerobic or mixed (aerobic/anaerobic) bacteria. The majority of infections are initiated by aerobic bacteria with anaerobic bacteria following. The synergy between the two can cause serious infections.
- Antibiotics are never a substitute for incision and drainage or other means to remove of the source of infection.
INDICATIONS FOR ANTIBIOTIC USE
- Rapidly progressing infection
- Diffuse tissue involvement
- Compromised host immune system
- Fascial space involvement
- Severe pericoronitis
CONSIDERATIONS WHEN CHOOSING AN ANTIBIOTIC
- Most appropriate spectrum activity
- Least adverse side effects
- Least expensive option
- Lowest potential drug-to-drug interaction
- Proper dosage
- For oral surgery, Penicillin fits most of the above criteria
WHEN ANTIBIOTIC USE MAY NOT BE NECESSARY
- Localized infections
- Minor abscess
- Mild pericoronitis
- Dry socket
- Viral infection
WHEN TO REFER
There may be occasions when it is necessary to refer a patient for medical care of an infection. Indications for this scenario include:
- High fever
- Voice changes
- Difficulty speaking, swallowing and/or opening mouth
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team