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4HE !MERICAN !CADEMY OF 0EDIATRIC $ENTISTRY RECOGNIZES THE &ACTORS RELATED TO HOST RISK EG AGE SYSTEMIC ILLNESS MALNUTRITION
INCREASING PREVALENCE OF ANTIBIOTIC RESISTANT MICRO ORGANISMS AND TYPE OF WOUND EG LACERATION PUNCTURE MUST BE EVALUATED
4HIS GUIDELINE IS INTENDED TO PROVIDE GUIDANCE IN THE PROPER WHEN DETERMINING THE RISK FOR INFECTION AND SUBSEQUENT NEED
AND JUDICIOUS USE OF ANTIBIOTIC THERAPY IN THE TREATMENT OF ORAL FOR ANTIBIOTICS 7OUNDS CAN BE CLASSIlED AS CLEAN POTENTIALLY
CONDITIONS CONTAMINATED OR CONTAMINATEDDIRTY &ACIAL LACERATIONS MAY
REQUIRE TOPICAL ANTIBIOTIC AGENTS )NTRAORAL LACERATIONS THAT AP
BZi]dYh PEAR TO HAVE BEEN CONTAMINATED BY EXTRINSIC BACTERIA OPEN FRAC
4HIS REVISION WAS BASED UPON A NEW SYSTEMATIC LITERATURE SEARCH TURES AND JOINT INJURY HAVE AN INCREASED RISK OF INFECTION AND
OF THE -%$,).%0UBMED ELECTRONIC DATABASE USING THE FOL SHOULD BE COVERED WITH ANTIBIOTICS )F IT IS DETERMINED THAT
LOWING PARAMETERS 4ERMS ANTIBIOTIC THERAPY ANTIBACTERIAL ANTIBIOTICS WOULD BE BENElCIAL TO THE HEALING PROCESS THE TI
AGENTS IN CHILDREN ANTIMICROBIAL AGENTS IN CHILDREN DENTAL TRAU MING OF THE ADMINISTRATION OF ANTIBIOTICS IS CRITICAL TO SUPPLE
MA ORAL WOUND MANAGEMENT OROFACIAL INFECTIONS PERIODONTAL MENT THE NATURAL HOST RESISTANCE IN BACTERIAL KILLING 4HE DRUG
DISEASE VIRAL DISEASE AND ORAL CONTRACEPTION &IELD !LL lELDS SHOULD BE ADMINISTERED AS SOON AS POSSIBLE FOR THE BEST RESULT
,IMITS WITHIN THE LAST  YEARS HUMANS %NGLISH CLINICAL TRIALS 4HE MOST EFFECTIVE ROUTE OF DRUG ADMINISTRATION INTRAVENOUS VS
BIRTH THROUGH AGE  0APERS FOR REVIEW WERE CHOSEN FROM THIS INTRAMUSCULAR VS ORAL MUST BE CONSIDERED 4HE CLINICAL EFFEC
SEARCH AND FROM HAND SEARCHING 7HEN DATA DID NOT APPEAR TIVENESS OF THE DRUG MUST BE MONITORED )F THE INFECTION IS NOT
SUFlCIENT OR WERE INCONCLUSIVE RECOMMENDATIONS WERE BASED RESPONSIVE TO THE INITIAL DRUG SELECTION A CULTURE AND SUSCEPTI
UPON EXPERT ANDOR CONSENSUS OPINION BY EXPERIENCED RESEARCH BILITY TESTING OF ISOLATES FROM THE INFECTIVE SITE MAY BE INDICATED
ERS AND CLINICIANS 4HE MINIMAL DURATION OF DRUG THERAPY SHOULD BE LIMITED TO
 DAYS BEYOND THE POINT OF SUBSTANTIAL IMPROVEMENT OR RESO
7VX`\gdjcY LUTION OF SIGNS AND SYMPTOMS THIS IS USUALLY A  TO  DAY
4HE WIDESPREAD USE OF ANTIBIOTICS HAS PERMITTED COMMON BACTE COURSE OF TREATMENT DEPENDENT UPON THE SPECIlC DRUG SELECT
RIA TO DEVELOP RESISTANCE TO DRUGS THAT ONCE CONTROLLED THEM  ED  4HE IMPORTANCE OF COMPLETING A FULL COURSE OF ANTIBIOTIC
!T PRESENT THERE ARE NO ANTIBIOTICS TO WHICH RESISTANCE HAS NOT MUST BE EMPHASIZED )F THE PATIENT DISCONTINUES THE ANTIBIOTIC
APPEARED 4O DIMINISH THE RATE AT WHICH RESISTANCE IS INCREA PREMATURELY THE SURVIVING BACTERIA CAN RESTART AN INFECTION THAT
SING HEALTH CARE PROVIDERS MUST BE PRUDENT IN THE USE OF MAY BE RESISTANT TO THE ORIGINAL ANTIBIOTIC
ANTIBIOTICS 
3PECIAL CONDITIONS
GZXdbbZcYVi^dch 0ULPITISAPICAL PERIODONTITISDRAINING SINUS TRACTLOCALIZED INTRA
#ONSERVATIVE USE OF ANTIBIOTICS IS INDICATED TO MINIMIZE THE ORAL SWELLING
RISK OF DEVELOPING RESISTANCE TO CURRENT ANTIBIOTIC REGIMENS  "ACTERIA CAN GAIN ACCESS TO THE PULPAL TISSUE THROUGH CARIES
4HE FOLLOWING GENERAL PRINCIPLES SHOULD BE ADHERED TO WHEN EXPOSED PULP OR DENTINAL TUBULES CRACKS INTO THE DENTIN AND
PRESCRIBING ANTIBIOTICS FOR THE PEDIATRIC POPULATION DEFECTIVE RESTORATIONS )F A CHILD PRESENTS WITH ACUTE SYMPTOMS
OF PULPITIS TREATMENT IE PULPOTOMY PULPECTOMY OR EXTRACTION
SHOULD BE RENDERED !NTIBIOTIC THERAPY USUALLY IS NOT INDICATED
IF THE DENTAL INFECTION IS CONTAINED WITHIN THE PULPAL TISSUE OR

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THE IMMEDIATELY SURROUNDING TISSUE )N THIS CASE THE CHILD WILL CAUSING OVULATION IN SOME INDIVIDUALS TAKING ORAL CONTRACEP
HAVE NO SYSTEMIC SIGNS OF AN INFECTION IE NO FEVER AND NO FACIAL TIVES #AUTION IS ADVISED WITH THE CONCOMITANT USE OF ANTI
SWELLING   BIOTICS AND ORAL CONTRACEPTIVES

!CUTE FACIAL SWELLING OF DENTAL ORIGIN GZ[ZgZcXZh

! CHILD PRESENTING WITH A FACIAL SWELLING SECONDARY TO A DENTAL  7ILSON 7 4AUBERT +! 'EVITZ 0 ET AL 0REVENTION OF IN
INFECTION SHOULD RECEIVE IMMEDIATE DENTAL ATTENTION $EPENDING FECTIVE ENDOCARDITIS 'UIDELINES FROM THE !MERICAN (EART
ON CLINICAL lNDINGS TREATMENT MAY CONSIST OF TREATING OR EXTRACT !SSOCIATION * !MERICAN $ENT !SSOC  3 3
ING THE TOOTHTEETH IN QUESTION WITH ANTIBIOTIC COVERAGE OR  ,EVY 3" -ULTIDRUG RESISTANCE ! SIGN OF THE TIMES .
PRESCRIBING ANTIBIOTICS FOR SEVERAL DAYS TO CONTAIN THE SPREAD OF %NGL * -ED   
INFECTION AND THEN TREATING THE INVOLVED TOOTHTEETH 4HE CLINI  .EU (# 4HE CRISIS IN ANTIBIOTIC RESISTANCE 3CIENCE 
CIAN SHOULD CONSIDER THE ABILITY TO OBTAIN ADEQUATE ANESTHESIA   
THE SEVERITY OF THE INFECTION AND THE MEDICAL STATUS OF THE  4ENOVER &# (UGHES *- 4HE CHALLENGES OF EMERGING
CHILD )NTRAVENOUS ANTIBIOTIC THERAPY ANDOR REFERRAL FOR MEDICAL INFECTIOUS DISEASES *!-!   
MANAGEMENT MAY BE INDICATED  !MERICAN !CADEMY OF 0EDIATRICS #$# !MERICAN 3OCIETY
FOR -ICROBIOLOGY 9OUR CHILD AND ANTIBIOTICS 5NNECES
$ENTAL TRAUMA SARY ANTIBIOTICS CAN BE HARMFUL !TLANTA 'A #$# 
,OCAL APPLICATION OF AN ANTIBIOTIC TO THE ROOT SURFACE OF AN AVULSED  #$# &OOD AND $RUG !DMINISTRATION .ATIONAL )NSTITUTES
TOOTH WITH AN OPEN APEX AND LESS THAN  MINUTES EXTRAORAL DRY OF (EALTH !CTION PLAN TO COMBAT ANTIMICROBIAL RESISTANCE
TIME HAS BEEN RECOMMENDED IF AVAILABLE TO INHIBIT EXTERNAL  !VAILABLE AT hHTTPWWWCDCGOVDRUGRESISTANCE
RESORPTION AND AID IN PULPAL REVASCULARIZATION   3YSTEMIC ACTIONPLANINDEXHTMv !CCESSED .OVEMBER  
ANTIBIOTICS HAVE BEEN RECOMMENDED AS ADJUNCTIVE THERAPY FOR  $OWELL 3& -ARCY 3- 0HILLIPS 72 'ERBER -! 3CHWARTZ
AVULSED PERMANENT INCISORS WITH AN OPEN OR CLOSED APEX   " 0RINCIPLES OF JUDICIOUS USE OF ANTIMICROBIAL AGENTS FOR
4ETRACYCLINE IS THE DRUG OF CHOICE BUT CONSIDERATION MUST BE PEDIATRIC UPPER RESPIRATORY TRACT INFECTIOUS 0EDIATRICS
EXERCISED IN THE SYSTEMIC USE OF TETRACYCLINE DUE TO THE RISK OF  
DISCOLORATION IN THE DEVELOPING PERMANENT DENTITION 0ENICILLIN  &INKELSTEIN *! -ETLAY *0 $AVIS 2, 2IFAS 3HIMAN 3,
6 CAN BE GIVEN AS AN ALTERNATIVE 4HE USE OF TOPICAL ANTIBI $OWELL 3& 0LATT 2 !NTIMICROBIAL USE IN DElNED POPULA
OTICS TO INDUCE PULPAL REVASCULARIZATION IN IMMATURE NON VITAL TIONS OF INFANTS AND YOUNG CHILDREN !RCH 0EDIATR !DOLESC
TRAUMATIZED TEETH HAS BEEN SUGGESTED  (OWEVER FURTHER -ED   
RANDOMIZED CLINICAL TRIALS ARE NEEDED  /"RIEN +, $OWELL 3& 3CHWARTZ " -ARCY - 0HILLIPS
72 'ERBER -! !CUTE SINUSITIS 0RINCIPLES OF JUDICIOUS
0EDIATRIC PERIODONTAL DISEASES USE OF ANTIMICROBIAL AGENTS 0EDIATRICS  
)N PEDIATRIC PERIODONTAL DISEASES EG NEUTROPENIAS 0APILLON  3CHWARTZ " "ELL $- (UGHES *- 0REVENTING THE EMER
,E&EVRE SYNDROME LEUKOCYTE ADHESION DElCIENCY  THE IMMUNE GENCE OF ANTIMICROBIAL RESISTANCE ! CALL TO ACTION BY
SYSTEM IS UNABLE TO CONTROL THE GROWTH OF PERIODONTAL PATHOGENS CLINICIANS PUBLIC HEALTH OFFICIALS AND PATIENTS *!-!
AND IN SOME CASES TREATMENT MAY INVOLVE ANTIBIOTIC THERAPY   
#ULTURE AND SUSCEPTIBILITY TESTING OF ISOLATES FROM THE INVOLVED  7ILLIAMS 2* (EYMANN $, #ONTAINMENT OF ANTIBIOTIC
SITES ARE HELPFUL IN GUIDING THE DRUG SELECTION RESISTANCE 3CIENCE   
 .AKAMURA 9 $AYA - 5SE OF APPROPRIATE ANTIMICRO
6IRAL DISEASES BIALS IN WOUND MANAGEMENT %MERG -ED #LIN .ORTH
#ONDITIONS SUCH AS ACUTE PRIMARY HERPETIC GINGIVOSTOMATITIS !M   
SHOULD NOT BE TREATED WITH ANTIBIOTIC THERAPY UNLESS THERE IS  7ICKERSHAM 2- .OVAK ++ 3CHWEAIN 3, ET AL 3YS
STRONG EVIDENCE TO INDICATE THAT A SECONDARY BACTERIAL INFECTION TEMIC ANTI INFECTIVES )N $RUG &ACTS AND #OMPARISONS
EXISTS 3T ,OUIS -O &ACTS AND #OMPARISONS  
 *OHNSON "3 /RAL INFECTION 0RINCIPLES AND PRACTICE OF
/RAL CONTRACEPTIVE USE ANTIBIOTIC THERAPY )NFECT $IS #LIN .ORTH !M 
7HENEVER AN ANTIBIOTIC IS PRESCRIBED TO A FEMALE PATIENT TAKING   
ORAL CONTRACEPTIVES TO PREVENT PREGNANCY THE PATIENT MUST BE  +URIYAMA 4 +ARASAWA 4 .AKAGAWA + 3AIKI 9 9AMAMOTO
ADVISED TO USE ADDITIONAL TECHNIQUES OF BIRTH CONTROL DURING % .AKAMURA 3 "ACTERIOLOGICAL FEATURES AND ANTIMICRO
ANTIBIOTIC THERAPY AND FOR AT LEAST  WEEK BEYOND THE LAST DOSE AS BIAL SUSCEPTIBILITY IN ISOLATES FROM OROFACIAL ODONTOGENIC
THE ANTIBIOTIC MAY RENDER THE ORAL CONTRACEPTIVE INEFFECTIVE INFECTIONS /RAL 3URG /RAL -ED /RAL 0ATHOL /RAL 2ADIOL
2IFAMPICIN HAS BEEN DOCUMENTED TO DECREASE THE EFFECTIVENESS OF %NDOD   
ORAL CONTRACEPTIVES /THER ANTIBIOTICS PARTICULARLY TETRACYCLINE  0ETERSON ,* !NTIBIOTICS FOR ORAL AND MAXILLOFACIAL INFEC
AND PENICILLIN DERIVATIVES HAVE BEEN SHOWN TO CAUSE SIGNIlCANT TIONS )N .EWMAN -' +ORNMAN +3 EDS !NTIBIOTIC
DECREASE IN THE PLASMA CONCENTRATIONS OF ETHINYL ESTRADIOL !NTIMICROBIAL 5SE IN $ENTAL 0RACTICE 3T ,OUIS -O
-OSBY  

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 -AESTRE 6ERA *R 4REATMENT OPTIONS IN ODONTOGENIC IN  3AE ,IM 6 7AND #9 4ROPE - %FFECT OF SYSTEMIC TETRA
FECTION -ED /RAL 0ATOL /RAL #IR "UCAL SUPPL 3  CYCLINE AND AMOXICILLIN ON INmAMMATORY ROOT RESORPTION OF
  REPLANTED DOGS TEETH %NDOD $ENT 4RAUMATOL 
 +EENAN *6 &ARMAN !' &EDOROWICZ : .EWTON *4 !   
#OCHRANE SYSTEM REVIEW lNDS NO EVIDENCE TO SUPPORT THE  )WAYA 3 )KAWA - +UBOTA - 2EVASCULARIZATION OF AN
USE OF ANTIBIOTICS FOR PAIN RELIEF IN IRREVERSIBLE PULPITIS * IMMATURE PERMANENT TOOTH WITH APICAL PERIODONTITIS AND
%NDOD    SINUS TRACT $ENT 4RAUMATOL   
 0RIETO 0RIETO * #ALVO ! -ICROBIOLOGICAL BASIS OF ORAL  4HIBODEAU " 4ROPE - 0ULP REVASCULARIZATION OF A NECRO
INFECTIONS AND SENSITIVITY TO ANTIBIOTICS -ED /RAL 0ATOL TIC INFECTED IMMATURE PERMANENT TOOTH #ASE REPORT AND
/RAL #IR "UCAL SUPPL 3   REVIEW OF THE LITERATURE 0EDIATR $ENT   
 !NDREASEN */ !NDREASEN &- !VULSIONS )N 4EXTBOOK  4HIBODEAU " 4EIXEIRA & 9AMAUCHI - #APLAN $* 4ROPE
AND #OLOR !TLAS OF 4RAUMATIC )NJURIES TO THE 4EETH TH ED - 0ULP REVASCULARIZATION OF IMMATURE DOG TEETH WITH
#OPENHAGEN $ENMARK "LACKWELL -UNKSGAARD  APECIAL PERIODONTITIS * %NDOD   
    "ANCHS & 4ROPE - 2EVASCULARIZATION OF IMMATURE PER
 #VEK - #LEATON *ONES 0 !USTIN * +LING - ,OWNIE * MANENT TEETH WITH APICAL PERIODONTITIS .EW TREATMENT
&ATTI / %FFECT OF TOPICAL APPLICATION OF DOXYCYCLINE ON PROTOCOL * %NDOD   
PULP REVASCULARIZATION AND PERIODONTAL HEALING IN REIM  $ELANEY *% +EELS -! 0EDIATRIC ORAL PATHOLOGY 3OFT TIS
PLANTED MONKEY INCISORS %NDOD $ENT 4RAUMATOL  SUE AND PERIODONTAL CONDITIONS 0EDIATR #LIN .ORTH !M
     
 ,EE *9 6ANN 7& 3IGURDSON !3 -ANAGEMENT OF AVULSED  !MERICAN !CADEMY OF 0EDIATRICS (ERPES SIMPLEX )N 2ED
PERMANENT INCISORS ! DECISION ANALYSIS BASED ON CHAN "OOK  2EPORT OF THE #OMMITTEE ON )NFECTIOUS $IS
GING CONCEPTS 0EDIATR $ENT    EASES TH ED %LK 'ROVE 6ILLAGE )LL !MERICAN !CADEMY
 4ROPE - 4REATMENT OF THE AVULSED TOOTH 0EDIATR $ENT OF 0EDIATRICS  
    $E2OSSI 33 (ERSH %6 !NTIBIOTICS AND ORAL CONTRACEP
 &LORES -4 !NDERSSON , !NDREASEN */ ET AL 'UIDELINES TIVES 0EDIATR #LIN .ORTH !M   
FOR THE MANAGEMENT OF TRAUMATIC DENTAL INJURIES )) !VUL  "URROUGHS +% #HAMBLISS -, !NTIBIOTICS AND ORAL CON
SION OF PERMANENT TEETH $ENTAL 4RAUMATOL  TRACEPTIVE FAILURE !RCH &AM -ED   
   $ICKINSON "$ !LTMAN 2$ .IELSEN .( 3TERLING -,
 -C)NTYRE *$ ,EE *9 4ROPTE - 6ANN 7& *R -ANAGEMENT $RUG INTERACTIONS BETWEEN ORAL CONTRACEPTIVES AND ANTI
OF AVULSED PERMANENT INCISORS ! COMPREHENSIVE UPDATE BIOTICS /BSTET 'YNECOL 0T  
0EDIATR $ENT   
 9ANPISET + 4ROPE - 0ULP REVASCULARIZATION OF REPLANTED
IMMATURE DOG TEETH AFTER DIFFERENT TREATMENT METHODS
%NDOD $ENT 4RAUMATOL   

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