ABSTRACT

How to avoid errors in antibiotic therapy in children

Because of increasing antibiotic resistance, the use of antibiotics should be strictly limited to specific clinical indications. In most cases of dental infections in paediatric patients without additional risk factors, a dentist’s intervention and local oral hygiene are sufficient. The Working Group of the Polish Dental Society (PTS) and the National Antibiotic Preservation Program emphasizes the importance of proper oral hygiene and the principles of procedural antisepsis in the prevention of dental infections. When deciding on any antibiotic therapy in children, it is important to establish strict indications for antibiotic use, taking into account the scope of action as well as the choice of an effective, and also safe, drug. The form and route of administration as well as the optimal dose per kilogram of body weight should be taken into account. Prophylactic antibiotics are used to prevent the spread of oral microorganisms from a local focus to distant organs in immunocompromised patients. Medical indications include the treatment of bacterial infection-related oral lesions in addition to local treatment. For empirical antibiotic therapy, the working group of the PTS and the National Antibiotic Preservation Program recommends the use of amoxicillin without clavulanic acid as first-line therapy, while reserving clindamycin therapy only for patients allergic to penicillin antibiotics. As prophylaxis, the drug should be administered only before surgery; an additional dose is justified only if postoperative wound healing is impaired or if the surgery was performed on inflamed tissues. Due to the special characteristics of infections in children, especially in the youngest patients, hospital treatment is often indicated.

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