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Title There Is Insufficient Evidence to Support the Use of Systemic Antibiotics to Prevent Postoperative Endodontic Flare-Ups
Clinical Question Is the incidence of postoperative endodontic flare-ups lower if antibiotics are given compared to endodontic therapy without antibiotics?
Clinical Bottom Line There is insufficient evidence to support the use of systemic antibiotics to prevent postoperative endodontic flare-ups.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24967571Cope/201462 participants in 2 trials Systematic review of randomized trials
Key resultsThere is insufficient evidence on the efficacy of systemic antibiotics to prevent flare-ups following endodontic therapy in adults. The two included studies reported no significant difference in pain or swelling between patients receiving antibiotics and those receiving placebo. In both studies, patients were given the test medication in conjunction with analgesics.
Evidence Search flare-ups[All Fields] AND ("anti-bacterial agents"[Pharmacological Action] OR "anti-bacterial agents"[MeSH Terms] OR ("anti-bacterial"[All Fields] AND "agents"[All Fields]) OR "anti-bacterial agents"[All Fields] OR "antibiotics"[All Fields])
Comments on
The Evidence
Validity: Both included studies were randomized controlled trials. One study had a high risk of bias, and the other study had an unclear risk of bias. The review included only two studies, and the sample size for both studies was small. Perspective:
Applicability These findings are applicable to all clinicians performing endodontic therapy. There is insufficient evidence to support the use of systemic antibiotics following endodontic therapy for the prevention of posttreatment pain and/or swelling. Clinicians should judiciously prescribe systemic antibiotics to their patients to prevent the development of antibiotic-resistant bacteria.
Specialty/Discipline (Endodontics) (General Dentistry)
Keywords Systemic antibiotics, postoperative endodontic treatment, flare-ups
ID# 2814
Date of submission: 03/17/2015spacer
E-mail trana2@livemail.uthscsa.edu
Author Aimy Tran
Co-author(s) e-mail
Faculty mentor/Co-author James Ball, DDS
Faculty mentor/Co-author e-mail BallJ@uthscsa.edu
Basic Science Rationale
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