Antibiotic prescribing
The 3-day review

Antibiotic stewardship refers to a set of coordinated strategies to optimise the use of antibiotics to achieve the best outcomes while reducing the risk of adverse events and antibiotic resistance.

A cornerstone of antibiotic stewardship is to ensure that antibiotics are only used when necessary and, when used, are selected and administered in a way that maximises their efficacy while minimising harm.

Assessing Response to Treatment:

Byy the third day, most patients on antibiotics for dental / oral infections should be showing signs of improvement. If they aren't, the clinician can reassess the diagnosis, or institute further local measures if these seem to have failed.

Addressing Adverse Reactions:

All antibiotics have potential side effects. A review after 3 days can identify if a patient is experiencing side effects, and if they are, the clinician can determine if the antibiotic should be stopped or changed.

Reassessing the Need for Antibiotics:

Sometimes, the initial decision to start antibiotics is made based on a presumptive or provisional diagnosis. A follow-up appointment is an opportunity to reassess the need for the antibiotics and discontinue them if they're not needed, reducing unnecessary antibiotic exposure.

Promoting Patient Engagement:

When patients know they have a scheduled follow-up, they may feel more empowered to voice any concerns or ask questions about their treatment. This can promote better adherence to the antibiotic regime and improve overall satisfaction with care.

Minimising Duration of Therapy:

Historically, many antibiotic courses were given for longer durations than necessary. Current guidelines recommend shorter courses for almost all dental / oral infections. A review at day 3 provides an opportunity to stop the antibiotic if the patient has improved significantly, potentially reducing the total duration of antibiotic use.

If an attended appointment is not possible, consider reviewing the patient via a phone call.