Segura-Egea J, Martın-Gonzalez J, Jimenez-Sanchez M, Crespo-Gallardo I, Sauco-Marquez J, Velasco-Ortega E. Int Dent J 2017; 67: 197–205

Systemic antibiotics are only appropriate in the treatment of apical periodontitis (AP) as an adjunct to endodontic therapy in cases where the host response is poor. AP is a polymicrobial infection, and the bacteria implicated in these infections are becoming resistant to currently available antibiotics.

This review highlights the antibiotic prescribing practices used in endodontic treatments in the Americas, Europe and Asia. Amoxicillin is frequently the antibiotic of choice (erythromycin or clindamycin for those allergic to penicillins). However, it was found that antibiotics were prescribed inappropriately for conditions such as localised pulpitis and symptomless draining sinus, which are more appropriately treated by endodontic therapy. The over prescription of antibiotics in the treatment of AP is a worldwide problem and further educational initiatives are required.