Guideline on the prudent prescription of antibiotics in the dental office

Good Clinical Practice (GCP)

Belgium is currently still one of the largest prescribers of antibiotics in Europe (in outpatient care). Around 6% of these antibiotics are prescribed by dentists. We therefore developed a clinical practice guide designed to encourage them to prescribe these drugs in a more reasoned fashion. This work was carried out in collaboration with practitioners in the field and academics. It contains recommendations for the use (or non-use) of antibiotics in a series of everyday situations in dentistry. Thus, for example, in the event of infection at oral environment level, the best approach is to treat the origin of the infection with an appropriate dental treatment, after which antibiotics are rarely necessary.

In fact, the use of antibiotics is rarely appropriate in dentistry. They should be envisaged when an infection appears to be spreading from a distance (swelling of the face or lymph nodes, fever, feeling of discomfort, etc.). When dental implants are fitted, it is also recommended that a single dose of antibiotics be administered before the operation. The same applies to invasive dental operations in people presenting a risk of endocarditis. Conversely, it is not necessary in people who have a knee or hip prosthesis.

The guideline is intended for general practitioners as well, since they sometimes also receive patients suffering from dental problems. When this occurs, it is important for them to refer these patients to a dentist so that the problem is correctly diagnosed and a start can be made on suitable dental treatment. There had hitherto not been any guideline of this kind in Belgium.

 KCE Reports 332: Guideline on the prudent prescription of antibiotics in the dental office