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Sir, increasing problems with antibiotic resistance mean that doses required to kill bacteria are rising. The most recent impact of this for dental professionals is that the dose of metronidazole recommended for treatment of oral infections has increased to 400 mg three times a day for up to five days, with review at three days. This dose increase follows advice from Public Health England (PHE).1 The rationale for change and supporting references can be found at the end of the document. Doses for children have also increased. Following publication of PHE advice the Faculty of General Dental Practitioners updated its online publication on the subject2 which is freely accessible via the Open Standards page on the FGDP website www.fgdp.org.uk.

Unfortunately, this recommended dose increase has come too late to be included in BNF 72 (available in September 2016 and to be distributed throughout the health service including to dentists with NHS contracts) and BNFC 2016/17 (published August 2016).3 However, the change may appear online between now and publication of the next paper issue of the BNF in March 2017.

Dentists will also be aware that in 2014 the dose of amoxicillin for oral infections was increased to 500 mg three times a day for up to five days, with review at three days, for all adults and children aged over 5 years old. This dose recommendation has been included in the BNF since September 2014 (BNF 68).

It is essential that dentists are aware of antibiotic dose changes and prescribe in accordance with recognised guidelines to help limit further antibiotic resistance.