Manejo de las infecciones odontogénicas en las consultas de atención primaria: ¿antibiótico? / Management of odontogenic infections in Primary Care: Antibiotic?

Nuestro objetivo es intentar contribuir al uso racional de los antibióticos prescritos por los médicos de familia cuando un paciente consulta por un problema odontológico. Actualmente la pregunta que nos debemos hacer es si hay que tomar antibiótico, en lugar de cuál dar. Revisamos las principales infecciones odontológicas, cuál debe ser el tratamiento adecuado y el papel de la prevención. Es necesario conocer la complejidad de la microflora de la cavidad oral, pues de ella dependerá la conveniencia de antibioterapia, la evolución hacia la curación o la progresión de algunas infecciones odontogénicas. La placa bacteriana, formada por el biofilm, se comporta como una barrera para la acción de los antimicrobianos. Es en la prevención de su formación, así como en la eliminación mecánica de esta una vez formada, en lo que el médico de familia debe insistir. Debemos transmitir a la población que los antibióticos no curan el dolor dental

Our aim is to contribute to the rational use of antibiotics prescribed by family doctors when a patient consults for a dental problem. Nowadays we should not ask which antibiotic to give. The question has to be if we need to prescribe antibiotics in front of the most common odontogenic infections seen in our practice. We review the main dental infections, which should be their appropriate management and the role of prevention. We need to know the complexity of the oral microbiome because it’l depend on the appropriateness of the antibiotherapy, the evolution towards cure or progression of some odontogenic infections. The bacterial plaque, formed by the biofilm, behaves as a barrier to the action of antimicrobials. It’s in the prevention of its development as well as in it mechanical elimination once shaped, in what the family doctor should insist. We must transmit antibiotics don’t heal dental pain

[Management of odontogenic infections in Primary Care: Antibiotic?] / Manejo de las infecciones odontogénicas en las consultas de atención primaria: ¿antibiótico?

Our aim is to contribute to the rational use of antibiotics prescribed by family doctors when a patient consults for a dental problem. Nowadays we should not ask which antibiotic to give. The question has to be if we need to prescribe antibiotics in front of the most common odontogenic infections seen in our practice. We review the main dental infections, which should be their appropriate management and the role of prevention. We need to know the complexity of the oral microbiome because it?ll depend on the appropriateness of the antibiotherapy, the evolution towards cure or progression of some odontogenic infections. The bacterial plaque, formed by the biofilm, behaves as a barrier to the action of antimicrobials. It?s in the prevention of its development as well as in it mechanical elimination once shaped, in what the family doctor should insist. We must transmit antibiotics don?t heal dental pain.

Me voy al dentista: ¿antibiótico como prevención o como tratamiento? / I’m going to the dentist: Antibiotic as a prevention or as a treatment?

Las infecciones odontogénicas representan el 10% de las prescripciones antibióticas. A pesar de la reconocida frecuencia e importancia de estas llama la atención la frecuente confusión entre profilaxis y tratamiento. La cavidad bucal forma un complejo ecosistema compuesto por más de 500 especies bacterianas. Es indispensable la anamnesis y exploración de cada infección y conocer los antecedentes que modifiquen nuestra conducta terapéutica y/o profiláctica. Durante muchos años ha sido aceptado el uso de la profilaxis con antibióticos en pacientes con riesgo de endocarditis infecciosa. Actualmente sus indicaciones se están restringiendo y en muchas ocasiones los riesgos de tomar antibiótico preventivo son superiores a los beneficios. Carecemos de estudios para conocer el antibiótico y la pauta mejor indicada. Hemos de basarnos en el documento de consenso español. Tampoco sabemos cómo influye el uso de antibióticos en las resistencias, no solo de la cepa patógena sino también en la flora habitual del paciente(AU)

Odontogenic infections account for 10% of all antibiotic prescriptions in Spain. Despite the frequency and importance of these infections, there is often confusion between prophylaxis and treatment. The oral cavity is a complex ecosystem made up of over 500 bacterial species. It is essential to take the medical history, examine each infection, and know about previous illnesses that could change our therapeutic and/or prophylactic attitude. The use of prophylaxis with antibiotics in patients at risk of infective endocarditis has been accepted for many years. Nowadays this is being restricted, and in many cases the risks of taking preventive antibiotics outweigh its benefits. There are no serious studies to determine the best antibiotic and its dosage, thus the Spanish consensus guidelines have to be followed. It is not known how the misuse of antibiotics influences bacterial resistance, not only on pathogen strains, but also on the common oral flora(AU)

[I'm going to the dentist: antibiotic as a prevention or as a treatment?]. / Me voy al dentista: ¿antibiótico como prevención o como tratamiento?

Odontogenic infections account for 10% of all antibiotic prescriptions in Spain. Despite the frequency and importance of these infections, there is often confusion between prophylaxis and treatment. The oral cavity is a complex ecosystem made up of over 500 bacterial species. It is essential to take the medical history, examine each infection, and know about previous illnesses that could change our therapeutic and/or prophylactic attitude. The use of prophylaxis with antibiotics in patients at risk of infective endocarditis has been accepted for many years. Nowadays this is being restricted, and in many cases the risks of taking preventive antibiotics outweigh its benefits. There are no serious studies to determine the best antibiotic and its dosage, thus the Spanish consensus guidelines have to be followed. It is not known how the misuse of antibiotics influences bacterial resistance, not only on pathogen strains, but also on the common oral flora.