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Review

Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review

1
Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
2
The National Centre for Antimicrobial Stewardship, Melbourne, VIC 3000, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Elena Maria Varoni
Antibiotics 2021, 10(3), 240; https://doi.org/10.3390/antibiotics10030240
Received: 7 January 2021 / Revised: 22 February 2021 / Accepted: 23 February 2021 / Published: 28 February 2021
(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)
Concerns regarding increasing antibiotic resistance raise the question of the most appropriate oral antibiotic for empirical therapy in dentistry. The aim of this systematic review was to investigate the antibiotic choices and regimens used to manage acute dentoalveolar infections and their clinical outcomes. A systematic review was undertaken across three databases. Two authors independently screened and quality-assessed the included studies and extracted the antibiotic regimens used and the clinical outcomes. Searches identified 2994 studies, and after screening and quality assessment, 8 studies were included. In addition to incision and drainage, the antibiotics used to manage dentoalveolar infections included amoxicillin, amoxicillin/clavulanic acid, cefalexin, clindamycin, erythromycin, metronidazole, moxifloxacin, ornidazole and phenoxymethylpenicillin. Regimens varied in dose, frequency and duration. The vast majority of regimens showed clinical success. One study showed that patients who did not receive any antibiotics had the same clinical outcomes as patients who received broad-spectrum antibiotics. The ideal choice, regimen and spectrum of empirical oral antibiotics as adjunctive management of acute dentoalveolar infections are unclear. Given that all regimens showed clinical success, broad-spectrum antibiotics as first-line empirical therapy are unnecessary. Narrow-spectrum agents appear to be as effective in an otherwise healthy individual. This review highlights the effectiveness of dental treatment to address the source of infection as being the primary factor in the successful management of dentoalveolar abscesses. Furthermore, the role of antibiotics is questioned in primary space odontogenic infections, if drainage can be established. View Full-Text
Keywords: antibiotics; dental; antibiotic resistance; dentoalveolar; odontogenic antibiotics; dental; antibiotic resistance; dentoalveolar; odontogenic
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MDPI and ACS Style

Teoh, L.; Cheung, M.C.; Dashper, S.; James, R.; McCullough, M.J. Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review. Antibiotics 2021, 10, 240. https://doi.org/10.3390/antibiotics10030240

AMA Style

Teoh L, Cheung MC, Dashper S, James R, McCullough MJ. Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review. Antibiotics. 2021; 10(3):240. https://doi.org/10.3390/antibiotics10030240

Chicago/Turabian Style

Teoh, Leanne, Monique C. Cheung, Stuart Dashper, Rodney James, and Michael J. McCullough 2021. "Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review" Antibiotics 10, no. 3: 240. https://doi.org/10.3390/antibiotics10030240

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