Antibiotic prescribing
The Last Word

Name: Antibiotic prescribing

Age: As old as the discovery of antibiotics in 1928, but the real fun began in the 1950s with the widespread use of these microbial miracle-workers.

Because antibiotics are lifesavers? Absolutely, they fight bacterial infections. But like every superhero, they have a weakness: overuse leads to resistant bacteria. They're not one-size-fits-all.

So, dentists just hand them out like sweets on Halloween? Not quite. UK dentists dole out 8% of all NHS primary care antibiotic scripts. But there's a thing called "antibiotic stewardship" they must stick to. It's like a sacred oath to only use antibiotics when local measures give a thumbs down.

But why not play it safe and always prescribe them? Here's the twist: antibiotics aren't harmless. They can kickstart a resistance apocalypse where antibiotics lose their mojo against bacteria. Plus, they can seriously mess with your gut's peacekeeping forces—the microbiome.

Got it. So when do dentists roll out the antibiotic big guns? When local treatments wave the white flag. Think unmanageable infections or when treatment is on pause, and there's a ticking time bomb of infection. Oh, and when the first signs of sepsis crash the party—big red alert there!

What's the first weapon of choice? Phenoxymethylpenicillin—a narrow spectrum agent. If that's a no-go, amoxicillin steps in. But if there's an allergy or recent penicillin use, it's time for the reserves: metronidazole or azithromycin. Third line? That's hospital-level stuff.

How long's the battle? Short and sweet—3 to 5 days. And here's the kicker: the 3-day review. It's like a pit stop to check if the infection's waving a white flag. If yes, antibiotics drop the mic.

What about a sneak attack before a procedure? Prophylaxis, you mean? The evidence is thin, like dental floss. It's generally a no-go for healthy patients. But for complex cases, just maybe. The patient needs the full briefing, though—risks, benefits, the whole shebang.

So, what's in the dentist's arsenal? The Dental Practitioner's Formulary—it's like a menu but for antibiotics. The usuals are there: Phenoxymethylpenicillin, Amoxicillin, Metronidazole, and a few others for special occasions.

Do say: "Antibiotics? Only if we must. Let's keep those bacteria guessing!"

Don't say: "Antibiotics are the duct tape of dentistry—works every time!"