Principles of anti-infective therapy

Antimicrobial drugs, along with competent surgical procedures, provide an effective means for restoration of oral health. In dentistry, antibiotics are indicated for either treatment of acute infections or for prophylactic coverage of patients at risk for developing bacterial endocarditis or other infections as the result of bacteremia caused by dental procedures. Whenever possible, a bactericidal agent is preferred because of greater effectiveness and less reliance on host defense mechanisms. For maximal effectiveness of antibiotic therapy of orodental infections, several factors must be evaluated in choosing an antibiotic: (1) antibacterial spectrum and specificity of the agent; (2) degree of bacterial resistance reported for the antibiotic; (3) concentrations achieved at various sites; (4) age, type, and extent of infection; and (5) various host factors.