PDF: Systemic use of antibiotics in endodontic infections

In addition to normal endodontic procedures, adjunctive strategies may be needed in cases where there is abscess formation.

The primary aim should be to achieve drainage. Where there is discrete and localized swelling, drainage by itself is considered sufficient without the need for additional medication.

Antibiotics are unnecessary in irreversible pulpitis, necrotic pulps and localized acute apical abscesses. 

Lack of blood circulation in the root canal in these scenarios prevents antibiotics reaching the area; that is, they are ineffective in eliminating the microorganisms. 

Cope et al. evaluated the effects of systemic antibiotics provided with or without surgical intervention, with or without analgesics, for symptomatic apical periodontitis or acute apical abscess in adults in a recent Cochrane review.

They concluded that there was very low-quality evidence, which was insufficient to determine the effects of systemic antibiotics in adults with symptomatic apical periodontitis or acute apical abscess. 

On the other hand, antibiotics are useful adjuncts in specific cases as they assist in the prevention of the spread of infection. 

Clearly, the clinician must identify these specific cases correctly and caution must be exercised both during the prescription of specific antibiotics and the duration of administration.

No comments:

| Distributed By JOJO Themes