Antibiotics Following Tooth XLA Flashcards
Pt presented w/ swelling post-XLA what hx would want to take?
PC - SOCRATES
HPC - extraction difficult, any difficulties/ complications, followed post-op instructions, smoking, any ab prescribed
Are ab given post XLA?
Ab should be give routinely following
What are clinical signs and symptoms of infection post XLA?
Fluctuant or firm selling next to socket
Spreading infection
Systemic symptoms - raised temp, increased BP, tachycardia and malaise
Limited mouth opening
Bad taste or smell in mouth
What is most common bacteria involved in odontogenic infection?
Streptococcus viridian
Fusobacterium
Mainly mixed aerobic/ anaerobic
What are roles of aerobic vs anaerobic bacteria?
Aerobes cause tissue hypoxia and create environment for anaerobes
Anaerobes cause pus formation
What is standard ab regime for dentoalveolar infection?
Amoxicillin 500mg TDS 5 days - can be supplemented metro 400mg for severe infection
What type of bacteria is metronidazole most effective for?
Anaerobic infections - such as long-standing acute apical abscess
What ab to use for pt w/ penicillin allergy?
Consult hospital/ practice policy
Commonly clarithromycin 250mg BD 7 days
What is recommended for pain relief in a adults?
1g paracetamol 4 x daily
400-600mg of ibuprofen 3-4x daily
What is dry socket?
Localised inflammation caused by early loss of blood clot from socket causing accumulation of debris
Recommended tx for dry socket?
Administer LA
Copious irrigation to remove dbris
Dressing open socket using alvogel
Reinforce POIG
If pt has dry socket and asks for ab what would say?
Local inflammation caused by debris rather than bacteria
Best managed by rinsing debris and packing
If prescribe inappropriately mean ab may not work as effectively for you in the future
