Antibiotics in Endodontics: a review

Area of Science:

• Oral Microbiology
• Infectious Diseases
• Pharmacology

Background:

• Antibiotic overuse and resistance are global health issues impacting oral microbiota.
• Odontogenic infections are often polymicrobial, leading to empirical antibiotic prescribing.
• Broad-spectrum antibiotic use is increasing, even when not indicated for conditions like symptomatic irreversible pulpitis.

Purpose of the Study:

• To review current literature on antibiotic indications in endodontics.
• To provide recommendations for antibiotic prescription in endodontic patients.
• To address the challenge of antibiotic resistance in dental infections.

Main Methods:

• Literature review of current scientific publications.
• Analysis of antibiotic use in endodontic patient care.
• Formulation of evidence-based recommendations for antibiotic prescribing.

Main Results:

• Antibiotics are often overprescribed for localized endodontic infections where drainage is primary.
• Adjunctive antibiotics are indicated for spreading infections, systemic involvement, or compromised patients.
• Penicillin VK, amoxicillin, or clindamycin (for penicillin allergy) are recommended based on efficacy and safety.

Conclusions:

• Judicious antibiotic use is crucial to combat resistance in endodontic treatment.
• Prioritize drainage for localized infections; reserve antibiotics for specific indications.
• Tailor antibiotic selection based on patient factors, infection severity, and resistance patterns.