ACUTE DENTOALVEOLAR INFECTIONS - AN INVESTIGATION OF THE DURATION OF ANTIBIOTIC-THERAPY

Objective To evaluate shortened courses of antibiotics in the manageme nt of dentoalveolar abscesses. Design Prospective clinical study over a 3-year period. Setting Examinations department of the Liverpool Univ ersity Dental Hospital. Subjects 759 patients, with acute dentoalveola r abscesses associated with swelling, and an elevation of axillary tem perature to above 38.5 degrees C, were included in the investigation. The minimum age of the patients was 16 years. Interventions The initia l treatment was to drain the abscess by incision (124 patients), or ex traction (635). The patients were prescribed amoxycillin (250 mg every 8 hours), clindamycin (150 mg every 6 hours) or erythromycin stearate (250 mg every 6 hours) and instructed to drink plenty of quid. All th e patients were seen 2 or 3 and 10 days later; only patients who were seen at these times were included in the trial. Main outcome measures Resolution of the swelling and a normal axillary temperature. Results At first review 748 patients (98.6%) had normal temperatures, marked r esolution of the swelling and the antibiotic was discontinued. None of these 748 patients required further antibiotic therapy. Conclusions T he duration of antibiotic therapy in most patients with acute dentoalv eolar infections can safely be 2-3 days, provided that drainage has be en established. It is not, therefore, necessary for the majority of pa tients to complete a 5-day course of antibiotics.