Sammanfattning
In order to prevent further development of bacterial resistance
to antibiotics the Danish Health and Medicines Authority has requested
professional guidelines describing proper clinical use of
antibiotics. This article deals with the basis for administration of
prophylactic antibiotics in dentistry. Indications exist in patients at
risk of developing local or general infectious disease due to either
severe general immunosuppression or locally increased susceptibility
(locus minoris resistentiae) and in otherwise healthy patients
undergoing extensive invasive procedures in the oral cavity.
However, a number of medical diseases and therapies causing
minor immunosuppression and performing of less extensive oral
treatment does not pose an indication for antibiotic prophylaxis.
The decision must always be based on a thorough evaluation of
the patient’s medical and oral risk factors. When prophylaxis is
indicated a single dose of amoxicillin (2 g) (clindamycin/roxithromycin
if the patient is allergic to penicillins), is administered per
os one hour before treatment. Furthermore, it is of the utmost
importance to maintain healthy oral and periodontal conditions
in patients at risk in order to reduce the incidence of bacteremia
and systemic dissemination of oral microorganisms during tooth
brushing and other daily activities.