​Previous late artificial joint infection

​Increased morbidity asso. w/ Joint surgery

​Severe and spreading oral infection

​Pt susceptibility for systemic infection

​Congenital or Acquired Immunodeficiency ​Trans catheter-implanted protheses

​Additional Consideration ​Prosthetic cardiac valves
​Pt on Immunosuppressive medicine ​Homografts

​Diabetics with poor glycemic control ​Prosthetic materials: Cardiac valve

​repair
​Rheumatoid artheitis
​e.g. ​Systemic Immunocompromising disorder
​Lupus erythematosus ​ATB Prophylaxis (AAE 2017) ​Previous Infective Endocarditis

​Before Extensive and Invasive procedures ​Unrepaired cyanotic congenital

​heart disease
​Cardiac Transplant with valve
​regurgitation ​Repaired congenital heat disease

​As ATB Prophylaxis

​Fever
​Present Sign&Symptoms of
​Malaise
​E.g. ​infection
​Swelling

​Pain

​Diabetes mellitus
​ATB prophylaxis if indicated
​Chronic renal failure

​Medical history or systemic

​Alcoholism ​Correct Diagnosis
​exam reveals Disease
​Chronic liver disease
​affecting host defense ​Consider therapeutic intervention
​Aging
​system ​Indication for ATB ​Risks
​Pt. On corticosteroids ​Weigh potential
​Benefits
​HIV/AIDS ​Pretreatment ​Prescribe ATB only for bacterial
​Leukemia
​infection
​Under Chemotherapy
​Underlying disease
​Under Radiation therapy
​Pregnancy status

​Clinical exam reveals ​Assess Medical history ​Drug allergies

​infection
​Drug-Drug interactions

​Use ATB as adjunct to ​Adverse events

​Surgical tx
​Identified causative organism

​Tx of abscess ​Determine ATB sensitivity

​Tx of Pericoronitis ​Use of specific, narrow spectrum ATB

​Tx of osteomyelitis
​Therapeutic uses of ​ ational
R ​Use of the least toxic ATB
​ATB in Oral-
​Antibiotic
​Pt. drug history
​ anagement of
M ​Maxillofacial surgery ​Use of bactericidal rather than a
​maxillofacial fractures
​ rinciple of
P
​Use in
​bacteriostatic drug

​Take ATB EXACTLY as prescribed

​choosing ATB ​Use of ATB with proven history of
​success

​Take ATB prescribed only for them ​Dentistry ​Cost of ATB

​Take ALL ATB prescribed ​Patient Education ​Ensure that Pt. Completes ATB course

​Not save ATB for future ​Age

​Renal Function
​Host related factors
​Amoxicillin ​Hepatic Function

​Local factors
​Ampicillin

​Penicillin
​Administer proper dose
​Amoxicillin-clavulanic acid ​Proper time interval
​Cephalexin ​Proper route of administration

​Cefazolin ​Principles of ATB ​Consistency in route of

​ATB commonly ​administration ​administration
​Clarithromycin
​prescribed in ​Combination ATB therapy
​Doxycycline
​dentistry ​Use ATB for shortest time possible
​Cefradine

​Metronidazole
​American Association of Endodontists. AAE Quick
​Clindamycin ​Reference Guide on Antibiotic Prophylaxis 2017
​Update. AAE; 2017.

​Azithromycin ​World Health Organization. Promoting Rational Use

​of Medicines: Core Components-WHO Policy

​Gentamycin ​Perspectives on Medicines. WHO; 2002.

​Singh Gill A, Morrissey H, Rahman A. A Systematic

​Review and Meta-Analysis Evaluating Antibiotic
​Prophylaxis in Dental Implants and Extraction
​Procedures. Medicina (Kaunas). 2018;54(6).
​References ​Poveda Roda R, Bagan JV, Sanchis Bielsa JM,
​Carbonell Pastor E. Antibiotic use in dental practice.
​A review. Med Oral Patol Oral Cir Bucal. 2007;12(3):
​E186-92.
​Nanticha Ruangchainicom
​6236682 PG Surg ​Shivanand S, Vidya CS,Satish Radhakrishna,Divya Rao,
​Pradeep subbhaiah. The Current Concepts in the Use
​of Antibiotics in Dental Practice. International Journal
​of Applied Engineering Research 2018;13(5):2959-64.