Sir, for well over three years now, immediately after the majority of adult extractions, I give the patient a single dose of 200mg Metronidazole. A patient returning with a post operative infected socket is now a rarity.

I am in a predominantly NHS practice and my prescribing profile from the DPB indicates that my extraction rate is higher than normal, and my extractions with special difficulty are relatively even higher, as I rarely refer. Despite some very difficult cases, the patient still only receives the one tablet.

The cost to me is negligible — each tablet costs me 7.5p (inc VAT!) and the only side effect for the patient is an alcohol free evening, which generally isn't a problem unless it's a Friday!

I implore my colleagues to do likewise and especially forget about a course of antibiotic therapy post operatively which I believe is an unnecessary use of antibiotics.