The use of antibiotics in odontogenic infections: what is the best choice? A systematic review

Publication date: Available online 17 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): João Roig Martins, Otacílio Luiz Chagas Júnior, Bibiana Dalsasso Velasques, Ângelo Niemczewski Bobrowski, Marcos Britto Correa, Marcos Antonio Torriani
PurposeOdontogenic infections are a common problem in dentistry and their treatment often requires the use of antibiotics besides the removal of the source of infection, which frequently makes it more difficult for clinicians to take a decision regarding the choice of antibiotic. This study aimed to answer the following questions through the PICO format: When should antibiotics be used in dental infections (DIs), which are the most effective drugs and for how long should they be administered?MethodsThis was a systematic review using PubMed, Scopus and Cochrane databases without restriction as to the period of time researched. The variables analyzed in each studied article were number of odontogenic infections in each study, type of study, surgical intervention performed, antibiotic administered, statistical differences between groups studied and patient's evolution after treatment.ResultsThe search included 1109 articles. After the full reading of 46 articles, 16 of them were included in the final review and 30 were excluded. A sample of 2197 dental infection cases was obtained, in which 15 different antibiotics were used, with a 98.2 % overall cure rate.ConclusionThe studies showed that antibiotics were prescribed only in situations of regional and / or systemic body manifestations. In the case of dental infections, once drainage has been performed and / or the cause of infection has been removed, all antibiotics tested are equally effective with respect to clinical cure, and the choice of antibiotics is not as successful as the local intervention treatment procedure. When a real need of antibiotic therapy is detected, antibiotics should be used for the shortest time possible until the patient's clinical cure is achieved.



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