ABSTRACT
BACKGROUND: Odontogenic infections, and especially endodontic infections, are polymicrobial, involving a combination of Gram-positive and Gram-negative facultative anaerobes and strictly anaerobic bacteria. Therefore, antibiotics can be used as an adjunct to endodontic treatment. However, most chronic and even acute endodontic infections can be successfully managed by disinfection of the root-canal system, which eliminates the source of infection, followed by abscess drainage or tooth extraction, without the need for antibiotics. The literature provides evidence of inadequate prescribing practices by dentists. The aim of this concise review was to analyse the worldwide pattern of antibiotic prescription in endodontic infections. METHODS: Comprehensive searches were conducted in MEDLINE/PubMed, Wiley Online Database, Web of Science and Scopus. The databases were searched up to 13 March 2016 for studies in which dentists used systemic antibiotics to treat endodontic lesions and which reported data on the type of antibiotic prescribed and on the diagnosis of the endodontic disease treated. RESULTS: The electronic and hand searches identified 69 titles, of which 25 were included in the final analysis. Amoxicillin was reported as the drug of choice for endodontic infections in most countries, and clindamycin and erythromycin were the choice for patients allergic to penicillin. Dentists worldwide prescribe antibiotics for non-indicated conditions, such as pulpitis. CONCLUSION: Antibiotics are overprescribed for the management of endodontic infections. It is necessary to improve antibiotic-prescribing habits in the treatment of endodontic infections, as well as to introduce educational initiatives to encourage the coherent and proper use of antibiotics in such conditions.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Drug Prescriptions/statistics & numerical data , Practice Patterns, Dentists' , Pulpitis/drug therapy , Africa , Asia , Australia , Europe , Humans , Prescription Drug Overuse/statistics & numerical data , South America , United StatesABSTRACT
Objetivo El objetivo de este ensayo clínico aleatorizado, doble ciego, de brazos paralelos y controlado por placebo fue evaluar el efecto clínico del consumo de Lactobacillus rhamnosus SP1 en un polvo de disolución oral, adicional a la terapia periodontal no quirúrgica. Material y método Cuarenta y nueve sujetos fueron examinados para participar en este estudio. Veintiocho participantes sistémicamente sanos, con diagnóstico de periodontitis crónica, fueron reclutados y monitorizados clínicamente en el tiempo basal, 3 y 6 meses después de la terapia periodontal. Los parámetros clínicos registrados fueron presencia de placa, sangrado al sondaje, profundidad al sondaje y pérdida de inserción clínica. Todos recibieron terapia periodontal no quirúrgica, incluyendo pulido y alisado radicular (PAR), y fueron asignados aleatoriamente al grupo experimental (PAR + probiótico, n = 14) o control (PAR + placebo, n = 14). Luego de la última sesión de PAR debieron ingerir un sobre con polvo de disolución oral de Lactobacillus rhamnosus SP1 o placebo, una vez al día durante 3 meses. Resultados Ambos grupos mejoraron sus parámetros clínicos en todos los tiempos evaluados. Además, el grupo experimental redujo significativamente el porcentaje de sitios, dientes y número de participantes con profundidad al sondaje ≥ 5 mm entre el tiempo basal y los 6 meses postratamiento. Conclusiones La administración oral de L. rhamnosus SP1 asociado a la terapia periodontal genera similares mejorías en los parámetros clínicos comparado con solo usar terapia periodontal en el tratamiento de la periodontitis crónica en adultos.
Objective The aim of this double- blind, placebo- controlled parallel- arm, randomised clinical trial was to evaluate the clinical effects of a sachet of Lactobacillus rhamnosus SP1-containing probiotic as an adjunct to non-surgical therapy. Material and method Fourty- nine subjects were screened for their elegibility to participate in this study. Twenty-eight systemically healthy volunteers with chronic periodontitis were enrolled and monitored clinically at baseline, and at 3 and 6 months after therapy. Clinical parameters measured included plaque index, bleeding on probing, pocket probing depths (PPD), and clinical attachment loss. Patients received non-surgical therapy including scaling and root planing (SRP), and were randomly assigned to a test (SRP + probiotic, n = 14) or control (SRP + placebo, n = 14) group. The administration of a sachet of Lactobacillus rhamnosus SP1 probiotic once a day for 3 months commenced after the last session of SRP. Results Both test and control groups showed improvements in clinical parameters at all time points evaluated. Furthermore, at initial visits and after 6 months follow-up, the test group showed a statistically significant reduction in percentage of sites, teeth, and number of participants with PPD ≥ 5 mm. Conclusions The results of this trial indicate that oral administration of L. rhamnosus SP1 sachets during initial therapy resulted in similar clinical improvements compared to SRP alone.