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      Antibiotic Prescribing for Oro-Facial Infections in the Paediatric Outpatient: A Review

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          Abstract

          There are many reports on the complications associated with antibiotics abuse during the treatment of paediatric patients, particularly those related to antimicrobial resistance. The dental profession is no exception; there is growing evidence that dental practitioners are misusing antibiotics in the treatment of their paediatric patients. This review is directed to dental practitioners who provide oral healthcare to children. It is also directed to medical practitioners, particularly those working in emergency departments and encountering children with acute orofacial infections. A systematic search of literature was conducted to explore the clinical indications and recommended antibiotic regimens for orofacial infections in paediatric outpatients. The main indications included cellulitis, aggressive periodontitis, necrotizing ulcerative gingivitis, and pericoronitis. Amoxicillin was found to be the most commonly recommended antibiotic for short durations of 3–5 days, with metronidazole or azithromycin being the alternative antibiotics in penicillin-sensitive patients.

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          Risks of population antimicrobial resistance associated with chronic macrolide use for inflammatory airway diseases.

          David Serisier (2013)
          Macrolide antibiotics have established efficacy in the management of cystic fibrosis and diffuse panbronchiolitis-uncommon lung diseases with substantial morbidity and the potential for rapid progression to death. Emerging evidence suggests benefits of maintenance macrolide treatment in more indolent respiratory diseases including chronic obstructive pulmonary disease and non-cystic fibrosis bronchiectasis. In view of the greater patient population affected by these disorders (and potential for macrolide use to spread to disorders such as chronic cough), widespread use of macrolides, particularly azithromycin, has the potential to substantially influence antimicrobial resistance rates of a range of respiratory microbes. In this Personal View, I explore theories around population (rather than patient) macrolide resistance, appraise evidence linking macrolide use with development of resistance, and highlight the risks posed by injudicious broadening of their use, particularly of azithromycin. These risks are weighed against the potential benefits of macrolides in less aggressive inflammatory airway disorders. A far-sighted approach to maintenance macrolide use in non-cystic fibrosis inflammatory airway diseases is needed, which minimises risks of adversely affecting community macrolide resistance: combining preferential use of erythromycin and restriction of macrolide use to those patients at greatest risk represents an appropriately cautious management approach. Copyright © 2013 Elsevier Ltd. All rights reserved.
          Article 0 comments Cited 52 times – based on 0 reviews     Review now
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            Antibiotics in Endodontics: a review

            A. Mazzoni, P M H Dummer, L Tjäderhane … (2017)
            The overuse of antibiotics and the emergence of antibiotic-resistant bacterial strains is a global concern. This concern is also of importance in terms of the oral microbiota and the use of antibiotics to deal with oral and dental infections. The aim of this paper was to review the current literature on the indications and use of antibiotics and to make recommendations for their prescription in endodontic patients. Odontogenic infections, including endodontic infections, are polymicrobial, and in most cases, the prescription of antibiotics is empirical. This has led to the increasing use of broad-spectrum antibiotics even in cases where antibiotics are not indicated, such as symptomatic irreversible pulpitis, necrotic pulps and localized acute apical abscesses. In case of discrete and localized swelling, the primary aim is to achieve drainage without additional antibiotics. Adjunctive antibiotic treatment may be necessary in the prevention of the spread of infection, in acute apical abscesses with systemic involvement and in progressive and persistent infections. Medically compromised patients are more susceptible to complication arising from odontogenic infections and antimicrobials have a more specific role in their treatment. Therefore, antibiotics should be considered in patients having systemic diseases with compromised immunity or in patients with a localized congenital or acquired altered defence capacity, such as patients with infective endocarditis, prosthetic cardiac valves or recent prosthetic joint replacement. Penicillin VK, possibly combined with metronidazole to cover anaerobic strains, is still effective in most cases. However, amoxicillin (alone or together with clavulanic acid) is recommended because of better absorption and lower risk of side effects. In case of confirmed penicillin allergy, lincosamides such as clindamycin are the drug of choice.
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              Global epidemiology of periodontal diseases in children and young persons

              Eduardo Tinoco, Jasim M Albandar (2002)
              Article 0 comments Cited 43 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Antibiotics (Basel)
                Journal ID (iso-abbrev): Antibiotics (Basel)
                Journal ID (publisher-id): antibiotics
                Title: Antibiotics
                Publisher: MDPI
                ISSN (Electronic): 2079-6382
                Publication date (Electronic): 25 April 2018
                Publication date Collection: June 2018
                Volume: 7
                Issue: 2
                Electronic Location Identifier: 38
                Affiliations
                [1 ]Dental College & Hospital, Taibah University, Al Madinah Al Munawwarah 42353, Saudi Arabia; hfadel@ 123456taibahu.edu.sa (H.T.F.); oabuhammad@ 123456taibahu.edu.sa (O.A.A.-H.)
                [2 ]Faculty of Dentistry, University of Jordan, Amman 11942, Jordan; s.abuhammad@ 123456yahoo.com
                [3 ]Department of Pediatrics, Ibn Alhaitham Hospital, Amman 11942, Jordan; ruaa.abdeljawad@ 123456hotmail.com
                Author notes
                [* ]Correspondence: ndarodeh@ 123456taibahu.edu.sa ; Tel.: +966-59-2231-888
                Author information
                https://orcid.org/0000-0001-9113-2399
                Article
                Publisher ID: antibiotics-07-00038
                DOI: 10.3390/antibiotics7020038
                PMC ID: 6022866
                PubMed ID: 29693642
                SO-VID: 135130d7-be05-4ab6-841d-174b9d61dbf7
                Copyright © © 2018 by the authors.
                License:

                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/).

                History
                Date received : 15 February 2018
                Date accepted : 24 April 2018
                Categories
                Subject: Review

                Keywords: antibiotics,prescribing,paediatric,orofacial infections,antimicrobial resistance
                Data availability:
                Keywords: antibiotics, prescribing, paediatric, orofacial infections, antimicrobial resistance

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