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.
Highlights
Antibiotics continue to be the most commonly prescribed drugs in children and adults [1].In England, for instance, it is estimated that 66.4% of dental prescriptions are antibacterial drugs [2].Variable rates of antibiotic prescribing among European countries are attributed to cultural and social factors, in addition to variable levels of awareness about the problem of antibiotic resistance among healthcare providers [3]
Papers published in English; Papers published in the past 20 years; Clinical trials; Case reports and series; Reviews; Expert opinions; Clinical guidelines; Patients: paediatric outpatients having orofacial infections; Intervention: prescribing regimen of antibiotics including: name, dose and duration
In the pre-antibiotic era, odontogenic infections were challenging to the oral surgeon, who had to deal with the frequently associated septic complications and fatal consequences [65]
Summary
Antibiotics continue to be the most commonly prescribed drugs in children and adults [1].In England, for instance, it is estimated that 66.4% of dental prescriptions are antibacterial drugs [2].Variable rates of antibiotic prescribing among European countries are attributed to cultural and social factors, in addition to variable levels of awareness about the problem of antibiotic resistance among healthcare providers [3]. Among members of the American Academy of Pediatric Dentistry, there was a trend toward overuse of antibiotics for non-indicated clinical conditions, like pain relief, irreversible pulpitis, and localised dentoalveolar abscess [5]. A similar trend was observed in developing countries, where a substantial proportion of dentists prescribe for non-indicated clinical conditions, such as dry socket, localised periapical infection, marginal gingivitis, periodontitis, and pulpitis [6]. This insufficient knowledge of the appropriate clinical indications is paralleled by lack of awareness of important interventions that promote the optimal use of antibiotics, such as antibiotic stewardship programs [5]. Other forms of abuse in prescribing antibiotics include prescribing broad-spectrum antibiotics for infections that
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