Pediatr Dent 2019 Jan;41(1):25-30
Dr. Sonis is a senior clinical associate, Department of Dentistry, Boston Children's Hospital, and a professor, Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Mass., USA.
The purposes of this study were to investigate prescribing patterns of antibiotics for the management of common pediatric oral infections, and to and identify the independent predictors of antibiotic preference across different groups of dental practitioners in Massachusetts, USA. A cross-sectional survey assessed antibiotic prescribing practices of general dentists, pediatric dentists, endodontists, and oral surgeons based on a series of clinical scenarios where antibiotic coverage may be warranted. The appropriate therapeutic management of patients with facial cellulitis occurred across all clinical groups. Endodontists were least likely to prescribe antibiotics for patients with irreversible pulpitis, and those with pulpal necrosis with associated parulis. Seventy-four percent of respondents prescribed antibiotics for patients suffering from pericoronitis and trismus. With the exception of the management of facial cellulitis, adherence to published guidelines for the prescription of antibiotics is low. Specifically, antibiotics are being prescribed too often for patients with tooth pain or localized abscesses and infrequently when the systemic spread of infection is less obvious, such as with trismus but no fever. Universally promulgated guidelines formulated by professional bodies may lead to improved adherence and a reduction in negative outcomes resulting from the overprescription of antibiotics.
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