Multi vs. single dose

Sir, I was heartened to read the letter from P. Williams (BDJ 2006; 200: 124) with regard to his success with a single tablet of 200mg metronidazole as a post-operative preventative of infection. This concurs with my own experience, published in the BDJ in February 2004, where a single dose 200mg metronidazole has (so far!) stopped all incidences of post-operative infection irrespective of surgical difficulty.

At a recent antibiotics course however, I was surprised to note that a centre of excellence still made no reference to small single dose therapy as being a reportedly good way to treat our patients, and that anything between five and 10 day courses of postoperative antibiotics are still being taught as the norm. This is despite the evidence from Professor Martin¹ and experiential evidence from oral surgeon practitioners such as Mr Williams or others.

As Mr Williams states, it really is time GDPs tried to cut down on the numbers of multi-dose courses of antibiotics in favour of single dose regimes, if only because although controversial, it appears to work. Consequently, I also urge colleagues to try it as part of their own regime.