Guideline on the Use of Antibiotic Therapy of the Pediatric Dental Patients

Guideline on the Use of Antibiotic Therapy of the Pediatric Dental Patients

AAPD Reference Manual V31, No. 6, 2009-10

Intro: Widespread use of antibiotics has resulted in resistance of common bacteria to antibiotics therefore necessitating conservative use of such antibiotics.

Wound Healing: Host factors such as age, systemic disease, malnutrition,and type of wound (clean, potentially contaminated, or dirty) all determine the need for antibiotics. Facial lacerations may require topical antibiotics. Intraoral lacerations contaminated by extrinsic bacteria, open fractures,and joint injuries are at increased risk of infection and thus require antibiotics. If antibiotics are needed, it should be given as soon as possible for the best result in the most effective route whether IV, IM, or oral. Antibiotics should be given for a minimum of 5 days beyond the time of significant improvement.

Special conditions:
Dental origin: If a child presents with acute symptoms of pulpitis, then treatment should be rendered, and usually antibiotics are not indicated. In this situation, the child should have no systemic signs of infection like a fever or facial swelling.

Facial swelling of dental origin: Antibiotics are indicated when there is evidence of facial swelling, and treatment is required immediately.

Dental trauma: Local application of antibiotics to the root of an avulsed tooth with an open apex with less than 60 Minutes of drying time. Systemic antibiotics are indicated with avulsions, usually tetracycline in older individuals and penicillin in younger patients.

Pediatric periodontal disease: Antibiotics are usually indicated due to inadequate immune response to protect against the growth of periodontal pathogens. Culture and susceptibility tests of isolate is helpfule .

Viral disease: Only use antibiotics if one suspects a secondary bacterial infection.

Oral Contraceptive use: Use caution when prescribing antibiotics on patients taking oral contraceptives as the antibiotics decrease the effectiveness of oral contraceptives. Tetracycline and penicillin like medications as well as Rifampicin all decrease plasma levels of ethinyl estradiol , causing ovulation.