Antibiotic resistance prevented from the dental office
Prudent and rational use of systemic antibiotics.
To prevent the spread of antibiotic resistance, according to the WHO, the general population should
- Use antibiotics only when prescribed by a certified health care professional.
- Always take the antibiotic for the specified time, even if you feel better.
- Never use leftover antibiotics.
- Never share antibiotics with others.
- Prevent infections by washing your hands frequently, covering your mouth when you sneeze, practicing food hygiene, avoiding contact with sick people, and keeping your vaccinations up to date.
As part of a global action plan against antimicrobial resistance, it is essential to carry out information campaigns for doctors and patients, strengthen surveillance and research (with the development of new drugs and vaccines), modify current behavior when using antibiotics, and adopt measures to reduce the incidence and spread of infections.
A problem at the dental level
Dentists are estimated to prescribe approximately 10% of antibiotics, so their role is essential in preventing and controlling antibiotic resistance. As advised by the WHO, dentists should ask themselves if they always apply infection prevention and treatment protocols and if they dispense antibiotics only when needed. According to current guidelines, if they teach patients how to take them correctly and explain to them what resistance is and what risks excessive use of these drugs entails; in addition, they should ask patients if they are taking or have taken antibiotics, and they should explain basic measures to prevent infections.
As the main recommendation, the dentist should not prescribe antibiotics as a substitute for proper dental treatment and never alone; you have to diagnose the cause of the infection, decide on the most appropriate dental treatment in that case and assess the need to prescribe antibiotics.
Approximately 90% of the antibiotic prescriptions made by the dentist have used drugs such as amoxicillin, metronidazole, and amoxicillin + clavulanic acid. A combination of antibiotics is chosen in 5.6% of the medications (the most frequent, amoxicillin + metronidazole).
However, it is recalled that the most effective method to prevent the development of resistance is using antibiotics only in those essential cases, at appropriate doses, and for the minimum duration possible to ensure the elimination of the pathogen involved in infection. A classic study (by Pallasch TJ et al.), which evaluated antibiotic resistance and its impact on the dental community, detailed the main misuses of antibiotic therapy in dental practice. Among other cases, this resource is misused in the prevention of post-surgical infection of unlikely occurrence, as an analgesic in endodontics as a pain reliever, in substitution of mechanical treatment, instead of incision and drainage, in the treatment of chronic periodontitis, when it is administered to prevent malpractice trials or when prescribed in inappropriate situations, doses, and duration.
