Sir, we refer to a recent letter from P. Williams on this subject (BDJ 2006; 200: 124). With the increasing problem of antimicrobial resistance and the potential serious side effects of antibiotics dentists have a moral and ethical duty to prescribe appropriately.1,2 To prescribe even a single dose of 200mg of metronidazole immediately after the majority of adult extractions, in our opinion, is an inappropriate use of antibiotics.
We would point the author to the scientific evidence which shows that the incidence of postoperative infections following extractions is extremely low (4%) and also to the evidence and guidelines that support our view.3,4,5,6,7,8 The clinical experiences of one practitioner undertaking a relatively small number of extractions does not constitute good scientific evidence. We would urge practitioners to follow the existing guidelines and consider using a local application of chlorhexidine rather than systemic antibiotics.9
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Palmer, N., Longman, L. Follow the guidelines. Br Dent J 200, 363 (2006). https://doi.org/10.1038/sj.bdj.4813444
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DOI: https://doi.org/10.1038/sj.bdj.4813444
