Tooth Infections and Antibiotic Myths #5-8

According to the American  Association of Endodontists:  

Myth #5:  Multiple antibiotics are superior to a single one:  Combined antibiotic therapy usually results in a greater selective pressure on the microbial population to develop drug resistance.  The primary clinical indication for combined therapy is a severe infection in which the offending organism is unknown and major consequences may ensue if antibiotic therapy is not instituted immediately before culture and sensitivity tests are available.  

Myth #6:  Bactericidal agents are always superior to bacteriostatic agents:  Bacteriocidal agents are required for patients with impaired defenses.  However, bacteriostatic agents are usually satisfactory when one's defenses against infections are unimpaired.  

Myth #7:  Antibiotic dosages, dosing intervals and duration of therapy are established for most infections:  Amount and timing of antibiotics are often unknown for most specific infections, due to the number of variables present.  Therefore, the current recommendation is to employ antibiotics on an intensive basis with vigorous dosage for as short a period of time as the clinical situation permits.  The goal is to achieve drug levels in the infected tissue.  Upon initiation of therapy, a loading dose is recommended.  

Myth #8:  Bacterial infections require a "complete course" of antibiotic therapy:  There is no such thing as a complete course since the only guide for determining the effectiveness of the therapy is the clinical improvement of the patient.  When there is sufficient evidence that the patient's defenses have regained control of the infection and that it is resolving or resolved, antibiotics should be terminated.  

See Myths #1-4

Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309