Daily Archives: November 17, 2017

Antibiotikagabe in der endodontie

Heute ging eine E-Mail der ESE, namentlich von Paul Dummer, mit folgendem Betreff  im Postfach ein. Nach dem englischen Text folgt ein PPT-Dokument zur Kampagne und die Links zu verschiedenen PDF’s. Ich finde es lohnt sich das zu lesen.

„ESE awareness campaign on the correct use of Antibiotics in Endodontics“

There is international concern about the overuse of antibiotics and the emergence of antibiotic-resistant bacterial strains. As dentists prescribe approximately 10% of antibiotics dispensed in primary care, it is important not to underestimate the potential contribution of the dental profession to the development of antibiotic-resistant bacteria. For example, in the UK, it has been reported that 40% of dentists prescribed antibiotics at least three times each week, and 15% prescribed antibiotics on a daily basis.

Antibiotics do not reduce pain or swelling arising from teeth with symptomatic apical pathosis in the absence of evidence of systemic involvement. Furthermore, one Cochrane systematic review has found no evidence to support the use of antibiotics for pain relief in irreversible pulpitis. Thus, two systematic reviews concluded that infection must be systemic or the patient must be febrile or immunocompromised to justify the need for antibiotics. For these reasons, prescription of antibiotics by dentists should be limited.

Odontogenic infections, including endodontic infections, are polymicrobial involving a combination of gram-positive, gram-negative, facultative anaerobes and strict anaerobic bacteria. When bacteria become resistant to antibiotics, they also gain the ability to exchange this resistance.

Antibiotic sensitivity of the bacteria found within the oral cavity is gradually decreasing, and a growing number of resistant strains are being detected, in particular Porphyromonas spp. and Prevotella spp. However, the phenomenon has also been reported for alpha haemolytic streptococci (‘Streptococcus viridans’) and for drugs such as macrolides, penicillin and clindamycin.

Inappropriate use of antibiotics not only drives antibiotic resistance and misuses resources but also increases the risk of potentially fatal anaphylactic reactions and exposes people to unnecessary side effects. In addition, antibiotic prescribing for common medical problems increases patient expectations for antibiotics, leading to a vicious cycle of increased prescribing in order to meet expectations.

ESE ABC Awareness campaign

Doppelklick auf den Link öffnet ein Fenster aus dem heraus die ppt-Datei heruntergeladen werden kann.

Ein wichtiger Anstoss, wie ich finde. Denn auch wir Zahnmediziner können dazu beitragen, die in meinen Augen weit verbreitete unreflektierte Antibiotikagabe zu reduzieren.

Das Statement der ESE , findet man hier:

http://onlinelibrary.wiley.com/doi/10.1111/iej.12781/full

Wer es lieber direkt mag, findet das PDF zum Download nachfolgend:

Segura-Egea_et_al-2017-International_Endodontic_Journal

Auch in der DZZ wird endlich wird geschrieben, was wir alle hier bestimmt längst schon wissen:

Der vermehrte Einsatz des Ausweichantibiotikums Clindamycin in der zahnärztlichen Versorgung stellt eine Fehlversorgung mit Antibiotika dar.

Wer es ein wenig ausführlicher nachlesen möchte, findet den Artikel unten angehängt.

Source:

https://wurzelspitze.wordpress.com/2017/11/10/antibiotikagabe-in-der-enddontie/