The Outcome of Prescribing Antibiotics for Management of Patients with Endodontic Infections

Abstract

Objective This study aimed to evaluate the efficacy and duration of antibiotic therapy with different regimens of antibiotics for patients presenting with primary and secondary endodontic infections. Methods In a case series outcome study, all patients needing antibiotics due to endodontic infection were included. In patients with no history of hypersensitivity to penicillin, amoxicillin was used as the first-line antibiotic, followed by adding metronidazole if the symptoms did not show signs of recovery during the first 24 hours after prescribing the medication. If a patient did not respond to the combination of amoxicillin and metronidazole, amoxicillin was substituted with a parental penicillin G procaine. Patients who had sensitivity to penicillin received clindamycin. In cases where drainage was possible, the effect of the procedure on the success rate of antibiotic therapy was evaluated. All patients were asked to continue taking the antibiotic for up to two days following the relief of symptoms. Data were analysed by Chi-square, Fisher exact test, Independent t-test, and One-way ANOVA. Results Over a period of 6 years, 97 patients were eligible to be included in this study. In patients with no history of sensitivity to penicillin (95.9% of the patients), 52.7% of patients on amoxicillin and 43% of patients on amoxicillin plus metronidazole overcame the endodontic infections. In addition, drainage significantly increased the success rate of antibiotic therapy when amoxicillin was prescribed (p=0.046). There were no significant differences between the gender, age, type of tooth, need for primary or secondary endodontic treatment, previous history of infection, need for drainage or duration of antibiotic consumption (p>0.05), and the success of antibiotic prescription. However, patients who received a single antibiotic (either amoxicillin or clindamycin) had significantly shorter average times for the recovery of symptoms (p<0.05). Conclusion Amoxicillin helped patients recover from endodontic infection symptoms in more than half of the cases. However, it is necessary to monitor the patients to understand if they should be needed further treatment, such as another antibiotic or drainage.

Examining the Frequency of Systemic Diseases in Patients Referring to the Dental Surgery Department

“…In addition, Ayazi and Esfehani (4) reported that the frequency of systemic diseases among clients referring to the Qazvin Faculty of Dentistry was 32%. Also, Al-Bayaty et al (9) in India, Mesgarzadeh et al (15) in Tehran, and Parirokh et al (12) in Tehran, Mashhad, and Kerman reported 42%, 41%, and 33.8%, respectively, as the prevalence of systemic diseases in the clients referring to dentistry faculties and private dental offices. In studies by Khader et al (16) in northern Jordan, Amirchaghmaghi et al (17) in Mashhad, and Kumar and Rajan (18) in southern India, the frequencies of systemic diseases were reported at 58.6%, 73.3%, and 52.8%, respectively, which are larger than the values reported in the present research.…”

“…In studies by Rezaei Estabraghi et al (7), Al-Bayaty et al ( 9), Mesgarzadeh et al (15), Kumar and Rajan (18), and Bayat et al (20), similar to the present study, hypertension and diabetes were reported as the most prevalent conditions. In addition, Taghibakhsh et al (11) reported hypertension and thyroid disease, Parirokh et al (12) reported cardiovascular diseases and hypertension, Ayazi and Esfehani (4) reported cardiovascular diseases and digestive disorders, and Khader et al (16) reported digestive disorders as the most frequent systemic diseases. Based on the present study and the mentioned ones, it can be found that the prevalence of all systemic diseases, especially hypertension and diabetes, has been growing in recent years.…”

“…In Iran, there is no consensus on the curriculum for educating about various medical conditions. It is important to note that common systemic diseases should be included and thoroughly studied in educational curricula (12). The goal is to prevent risky events in dentistry activities as much as possible.…”