Refresher: Why use anti-infectives?
This summary is based on the Clinical Info provided by the Canadian Pharmacists Association: Drugs in Dentistry (December 2012)
By Dr. Dan Haas, DDS, PhD, FRCDC
Consider the following points when using antibiotics:
- Use only when there is an indication.
- Use only when the risk-benefit ratio is favourable.
- They are not a substitute for establishing adequate drainage.
- Choose an effective agent with the narrowest spectrum of activity.
- Prescribe a therapeutic dose.
- Consider a loading dose.
- Prescribe at an appropriate frequency.
- Prescribe for an appropriate duration.
- Choose the drug with the fewest side effects.
- Consider laboratory culture and sensitivity tests to target specific bacteria with antibiotics identified as effective.
- Recognize that antibiotics encourage development of resistance if used for too long and/or at suboptimal doses.
- In superficial infections, consider alternatives to antibiotics such as topical debridement and application of topical antiseptics when appropriate.
- Consider individual patient factors such as age, allergies and drug interactions, especially with azole antifungals (fluconazole, itraconazole, ketoconazole), clarithromycin, erythromycin, metronidazole, tetracyclines; consult individual product monographs and drug interaction references.
- Consider cost.
Antibacterial Dosages for Orofacial Infections
Antifungals for the Treatment of Oral Candidiasis
References
- Haas DA. Adverse drug interactions in dental practice: interactions associated with analgesics, Part III in a series. J Am Dent Assoc 1999;130(3):397-407.
- United States Pharmacopeial Convention. USP DI Volume 1: Drug information for the health care professional. 24th ed. Englewood (CO): Micromedex; 2004.
- Haas DA. An update on analgesics for the management of acute postoperative dental pain. J Can Dent Assoc 2002;68(8):476-82.
- Haas DA, Epstein JB, Eggert FM. Antimicrobial resistance: dentistry’s role. J Can Dent Assoc 1998;64(7):496-502.
- Levine M, Lexchin J, Pellizzari R, editors. Drugs of choice: a formulary for general practice. 3rd ed. Ottawa (ON): Canadian Medical Association; 1998. p. 78.
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Excellent post. Can you publish Pediatric doses as well please?
Hello Dr. Stein,
I will certainly look into your question.
Cheers, JCDA Oasis Team