Has the antibiotic course had its day?
The Faculty of General Dental Practice (FGDP(UK)) has responded to ‘The antibiotic course has had its day’, the widely-publicised article in the latest edition of the British Medical Journal, which challenges the advice given to patients to complete courses of antibiotics even once an infection has been resolved.
Nikolaus Palmer, editor of FGDP(UK)’s Antimicrobial Prescribing for General Dental Practitioners, said, “This will be nothing new for dentists. Our advice since publishing the first edition of our guidance in 2001, and in line with the BNF and scientific evidence, has always been that courses of antibiotics should not be unduly prolonged, because they encourage resistance and may lead to side-effects. Where antibiotics are indicated in the management of dental infections as an adjunct to definitive treatment such as drainage, the evidence is clear that complete resolution occurs within three days in most cases. We recommend that antibiotics should be prescribed where indicated for up to five days, with patients being reviewed at two to three days and discontinuing antibiotic use where there is resolution of temperature and swelling. Patients should be advised to return any unused medication to their local pharmacy for safe disposal.”
Antimicrobial Prescribing for General Dental Practitioners provides guidance on the prescribing of antimicrobials to adults and children in primary dental care, giving clear, simple and practical advice on when to prescribe, what to prescribe, for how long and at what dosage. It is available in hard copy, as an e-book and free of charge online, and dentists should refer to the guidance for further information covering the choice and dosage of antimicrobial, and the management of other dental and oral infections.
FGDP(UK) has also co-produced a number of free resources for dentists, including an antimicrobial prescribing self-audit tool, ‘Antibiotics don't cure toothache’ poster and a patient information leaflet.
The antibiotic course has had its day (BMJ 2017; 358: j3418) is available at www.bmj.com/content/358/bmj.j3418