What is the role of antibiotic stewardship in dental practice?

• A. Use broad-spectrum antibiotics first.
• B. Avoid all antibiotics.
• C. Use narrow-spectrum antibiotics when possible, avoid unnecessary prophylaxis, complete prescribed courses, minimize resistance.
• D. Prescribe antibiotics for every patient.

Answer: (C)

Antibiotic stewardship in dental practice means using antibiotics only when they’re truly needed and choosing targeted therapy to reduce resistance while still effectively treating infection. When antibiotics are indicated, opt for a narrow-spectrum agent that covers the most likely oral pathogens, at the right dose, for the shortest effective duration. Reserve broader-spectrum drugs for specific situations (such as penicillin allergy or proven resistant organisms) rather than using them routinely. Avoid unnecessary prophylaxis by following current guidelines on who truly needs it, and emphasize proper source control—drainage, debridement, or removal of infected tissue—since antibiotics alone often aren’t enough. Also, complete the prescribed course and reassess if the patient doesn’t improve. This approach minimizes disruption to the normal microbiota, reduces adverse effects, and helps prevent the spread of resistance.

Using broad-spectrum antibiotics first promotes resistance and more side effects; avoiding all antibiotics risks undertreating infections; prescribing antibiotics for every patient is inappropriate and fuels resistance.