28 January 2022

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Antibiotic in pediatric dentistry: when prescription is necessary?

Simona Chirico

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Antibiotics can be considered one of the drugs which have mostly revolutionised healthcare. They are commonly used in dentistry both for prophylactic and for therapeutic issues thanks to their skills to achieve adequate control of infections.  Thus antibiotics continue to be the most commonly prescribed drugs (in children and adults). This increasing-and sometimes unjustified-trend, has now led to the origin of another worldwide problem, which is the antibiotic resistance. Uncontrolled use of antibiotics has been documented even in pediatric dentistry, where administration of drugs to children is further complicated by the necessity to adjust the dosages. This inappropriate knowledge of the correct clinical indications for prescriptions, together with a lack of scientific literature support has contributed to the rise of antibiotic resistance among pediatric patients. Hence definitive indications to regulate the use of antibiotics is necessary. 

This paper published on J Family Med Prim Care on February 2020, reviews the current literature from the year 2000 to 2019, aiming to create awareness regarding the use of antibiotic treatment in pediatric patients.

Materials and Methods
Data for this review were collected both manually from comprehensive textbooks and from electronic literature search in MEDLINE/PubMed, EBSCO host, and Google Scholar databases. Some recommendations were also based on the opinion of experienced researchers and clinicians.

Results
Choice of the antibiotics may be challenging to the pediatric dentists who have to consider various clinical situation while prescribing antibiotic therapy. Short courses are preferred to long courses, since children's compliance is generally poor.
Fluoroquinolones and tetracycline should be avoided in children.
Amoxicillin-clavulanic acid cover a broad spectrum and is considered safe.
Viral infections shouldn’t be treated with antibiotic.

Conclusions
In order to minimize the risk of developing resistance to current antibiotic a conservative use of antibiotics is indicated. Guidelines for dental antibiotic prescriptions in children are required to increase dentists awareness.

For additional information: Antibiotic prescriptions in pediatric dentistry: A review