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Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review

Concerns regarding increasing antibiotic resistance raise the question of the most appropriate oral antibiotic for empirical therapy in dentistry. The aim of this systematic review was to investigate the antibiotic choices and regimens used to manage acute dentoalveolar infections and their clinical...

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Autores principales: Teoh, Leanne, Cheung, Monique C, Dashper, Stuart, James, Rodney, McCullough, Michael J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997333/
https://www.ncbi.nlm.nih.gov/pubmed/33670844
http://dx.doi.org/10.3390/antibiotics10030240
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author Teoh, Leanne
Cheung, Monique C
Dashper, Stuart
James, Rodney
McCullough, Michael J
author_facet Teoh, Leanne
Cheung, Monique C
Dashper, Stuart
James, Rodney
McCullough, Michael J
author_sort Teoh, Leanne
collection PubMed
description Concerns regarding increasing antibiotic resistance raise the question of the most appropriate oral antibiotic for empirical therapy in dentistry. The aim of this systematic review was to investigate the antibiotic choices and regimens used to manage acute dentoalveolar infections and their clinical outcomes. A systematic review was undertaken across three databases. Two authors independently screened and quality-assessed the included studies and extracted the antibiotic regimens used and the clinical outcomes. Searches identified 2994 studies, and after screening and quality assessment, 8 studies were included. In addition to incision and drainage, the antibiotics used to manage dentoalveolar infections included amoxicillin, amoxicillin/clavulanic acid, cefalexin, clindamycin, erythromycin, metronidazole, moxifloxacin, ornidazole and phenoxymethylpenicillin. Regimens varied in dose, frequency and duration. The vast majority of regimens showed clinical success. One study showed that patients who did not receive any antibiotics had the same clinical outcomes as patients who received broad-spectrum antibiotics. The ideal choice, regimen and spectrum of empirical oral antibiotics as adjunctive management of acute dentoalveolar infections are unclear. Given that all regimens showed clinical success, broad-spectrum antibiotics as first-line empirical therapy are unnecessary. Narrow-spectrum agents appear to be as effective in an otherwise healthy individual. This review highlights the effectiveness of dental treatment to address the source of infection as being the primary factor in the successful management of dentoalveolar abscesses. Furthermore, the role of antibiotics is questioned in primary space odontogenic infections, if drainage can be established.
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spelling pubmed-79973332021-03-27 Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review Teoh, Leanne Cheung, Monique C Dashper, Stuart James, Rodney McCullough, Michael J Antibiotics (Basel) Review Concerns regarding increasing antibiotic resistance raise the question of the most appropriate oral antibiotic for empirical therapy in dentistry. The aim of this systematic review was to investigate the antibiotic choices and regimens used to manage acute dentoalveolar infections and their clinical outcomes. A systematic review was undertaken across three databases. Two authors independently screened and quality-assessed the included studies and extracted the antibiotic regimens used and the clinical outcomes. Searches identified 2994 studies, and after screening and quality assessment, 8 studies were included. In addition to incision and drainage, the antibiotics used to manage dentoalveolar infections included amoxicillin, amoxicillin/clavulanic acid, cefalexin, clindamycin, erythromycin, metronidazole, moxifloxacin, ornidazole and phenoxymethylpenicillin. Regimens varied in dose, frequency and duration. The vast majority of regimens showed clinical success. One study showed that patients who did not receive any antibiotics had the same clinical outcomes as patients who received broad-spectrum antibiotics. The ideal choice, regimen and spectrum of empirical oral antibiotics as adjunctive management of acute dentoalveolar infections are unclear. Given that all regimens showed clinical success, broad-spectrum antibiotics as first-line empirical therapy are unnecessary. Narrow-spectrum agents appear to be as effective in an otherwise healthy individual. This review highlights the effectiveness of dental treatment to address the source of infection as being the primary factor in the successful management of dentoalveolar abscesses. Furthermore, the role of antibiotics is questioned in primary space odontogenic infections, if drainage can be established. MDPI 2021-02-28 /pmc/articles/PMC7997333/ /pubmed/33670844 http://dx.doi.org/10.3390/antibiotics10030240 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Review
Teoh, Leanne
Cheung, Monique C
Dashper, Stuart
James, Rodney
McCullough, Michael J
Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review
title Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review
title_full Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review
title_fullStr Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review
title_full_unstemmed Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review
title_short Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review
title_sort oral antibiotic for empirical management of acute dentoalveolar infections—a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997333/
https://www.ncbi.nlm.nih.gov/pubmed/33670844
http://dx.doi.org/10.3390/antibiotics10030240
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