Indication for Use of Antibiotic (General Guidelines)

Indication for use of antibiotics (general guidelines) 1. Cellulites 2. Compromised host defense 3. Periocoronitis 4. Osteomyelitis 5. Involvement of vital structures (space infection, airway obstructions) 6. Systemic manifestation (fever, malaise) 7. Oroantral communication 8. As prophylactic (SAB Endocarditis, V-P shunt)

Antibiotics not indicated in: 1. Well localized abscess 2. Dry socket 3. Mild periocoronitis

Indications for culture and sensitivity testing: 1. Nonresponsive infection in spite of appropriate treatment. 2. Compromised host defenses (immunocompromised, myelosupressed patients) 3. When atypical flora may be expected (the use of long term antibiotics, age extremes <65 y or > 2y , patients with malignancy) 4. Osteomyelitis 5. Life threatening systemic infections. 6. Suspected actinomycosis 7. Pharyngeal infections

Patients at risk for bacterial endocarditis:

1. 1.Rheumatic valvular diseases 2. Mitral valve prolapse and mitral regurgitation 3. Acquired valvular diseases: - Calcific aortic stenosis in elderly patients - Aortic insufficiency secondry to trauma - Aortic insufficiency in syphilis

4. Congenital heart diseases Mitral valve prolapse with regurgitation Ventricular septal defect Idiopathic hypertrophic subaortic stenosis Bicuspid aortic valve Tetralogy of Fallot

5. Intravascular prosthesis 6. Coarctation of the aorta 7. Previous bacterial endocarditis 8. Prosthetic heart valve 9. Systemic-pulmonary shunt or conduit