Third molar surgery and antibiotic use

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This review of antibiotic prophylactic treatments in relation to the risk of developing dry socket (DS) and site-specific infection (SSI) after lower third molar extraction included 16 RCTs. Antibiotic did reduce the risk of DS and SSI in health patients but the number needed to treat (NNT) was high so the use should be considered only after a careful assessment of an individual patient’s risk.

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Chronic periodontitis: Efficacy of adjunctive antimicrobials

Many drugs are licensed for use in Generalised Anxiety Disorder (GAD), but it is unclear what works best.

This review of the efficacy of antimicrobials adjunctive to scaling and root planing (SRP) in the treatment of chronic periodontitis. 21 RCTs were included with the findings showing that amoxicillin and metronidazole had the largest statistical benefit. Whether this benefit is a clinically important benefit is a wider question.

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Periodontitis: Systemic antimicrobials as an adjunct to non-surgical treatment

Periodontal disease
Periodontitis

This Cochrane review of the effects of systemic antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis identified 45 RCTs. However the evidence is of very low certainty to inform tclinicians and patients if adjunctive antibiotics are beneficial.

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Azithromycin as an adjunctive antibiotic in non-surgical periodontal therapy

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Another new review of local or systemic azithromycin as an adjunct in non-surgical periodontal therapy includes 14 RCTs and demonstrates small benefits in periodontal parameters. However, the included studies are small and it is unclear if the benefits are clinically important.

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Azithromycin as an adjunct to scaling and root planing for periodontal disease

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This review of azithromycin as an adjunct to scaling and root planing for periodontal disease included 9 small RCTs. While some studies demonstrated some small improvements in periodontal parameters, there was no data to demonstrate superiority of azithromycin against the standard antibiotic combination of metronidazole and amoxicillin.

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Aggressive periodontitis: systemic antibiotics may improve outcome

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This review and network meta-analysis included 11 small RCTs of limited quality, suggesting a statistically significant benefit for the use of adjunctive systemic antibiotics for the treatment of aggressive periodontitis.

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Review finds only a small benefit from antibiotic use in patients with acute sinusitis

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Sinusitis is one of the commonest reasons for visiting the doctor accounting for 15% to 21% of all adult outpatient antibiotic prescriptions. Patients may also present at dental practices, as pain from upper posterior teeth can be indistinguishable from sinusitis.  Typical signs and symptoms are purulent nasal discharge, postnasal drip, sinus pain at palpation, nasal [read the full story…]