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Trends of usage of antimicrobial agents in dental practice on the basis of prescription analysis. Oral cavity organisms . more than 400 species Aerobic as well as anaerobic Anerobic 10 – 100 times more Spirochetes, Candida, viral. To deal with -. Dental Caries

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oral cavity organisms
Oral cavity organisms
  • more than 400 species
  • Aerobic as well as anaerobic
  • Anerobic 10 – 100 times more
  • Spirochetes, Candida, viral
to deal with
To deal with -
  • Dental Caries
  • Dentoalveolar abscess, pulp infection, periapical abscess
  • Gingivitis
  • Periodontitis – pericoronitis, periodontal abscess, osteomyelitis, peri-implantitis
  • Deep fascial infection
indications for chemotherapeutic agents
Indications for Chemotherapeutic Agents
  • Orodental Infections
  • To prevent other infections – bacterial endocarditis
  • To prevent postoperative infection
  • Improve healing
aims of study
Aims of study
  • To get general idea of prescribing trends
  • Comparing the trends in institutional practice and private practice
  • To analyze the prescriptions in order to determine -
    • The rationale - indications, adequacy of dosage, and duration of treatment
    • The adequacy for prophylaxis
    • The attention given to - contraindications and precautions
period of study 01 01 05 06 30 05 6 months
Period of study: 01/01/05–06/30/05: 6 months

Material: OPD antimicrobial Prescriptions

  • Data collected from –


¤ GDP: 20 (General Dental Practitioners)

other remarkable observations
Other remarkable observations
  • Ciprofloxacin ( up to 5 years): 1.3%
  • Ciprofloxacin ( 5-10 years): 2.7%
  • Ciprofloxacin ( > 10 years): 3%
  • Inadequate frequency of admn
  • Amoxicillin: 250 mg bid: 16.7%
  • Ampicillin: 250 mg bid: 15%
timing of treatment prophylaxis
Timing of treatment/prophylaxis
  • Inadequate duration: 19.4%

Ciprofloxacin single dose, Amoxicillin 2 days, Ampicillin 2 days

  • Antibiotic started after the procedure: 61.3%
oro dental infections
  • Periapical/Periodontal Abscess
  • Acute Suppurative pulpitis/Toxic cellulitis.
  • Salivary Gland Sepsis/Sinusitis
  • Post Surgical/Post Traumatic.
  • Oro-antral/Oro-nasal Fistula.
  • Ludwig’s angina/Purulent osteitis
  • Pericoronitis/Mucositis/Pemphigus
prophylaxis prevention
Prophylaxis (Prevention)
  • Bacterial Endocarditis.
  • Prosthetic Joint Infections.
  • Immuno-Compromised Hosts.
  • Procedures and others.
sbe prophylaxis


  • Extractions, Periodontal procedures
  • Prophylactic cleaning
  • Implant placement, Re-implantation
  • Endodontic Instrumentation/Surgery beyond root apex, Placement or removal of orthodontic bands
  • Intraligamentary LA
sbe prophylaxis 1

(1 hr before procedure)


Amoxicillin 2 g


Clindamycin 600 mg

Cephalexin/Cefadroxil 2 gm

Clarithromycin/Azithromycin 500 mg

sbe prophylaxis 2

30 mins before procedure)

  • Failure to take P/O

Ampicillin 2 gm IM/IV

  • Penicillin allergy & Failure to take P/O

Clindamycin 600 mg IV

Cefazolin 1 gm IM/IV

  • Most commonly prescribed antimicrobials were quinolones in combination with metronidazole and tinidazole (51% ).
  • Amongst the quinolones, ciprofloxacin and ofloxacin were the quinolones chosen by 95% of the prescribers.
  • Quinolones – ciprofloxacin, ofloxacin were prescribed alone by 10% prescribers.
4. Inadequacy of the frequency of administration was found in 15-17% prescriptions.
  • 5. Inadequate duration of treatment was observed in 19.4% prescriptions.
  • 6. First generation quinolones were prescribed to the children in the range of 1-3% of the prescriptions given for quinolones.
  • 7. The antimicrobial agent was started AFTER THE PROCEDURE in about 61% cases.

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