The increasing prevalence of multi resistant bacteria in community-associated infections is most likely caused by over-prescription of antibiotics. The majority of dental infections can be successfully treated with an accurate diagnosis and timely dental treatment without antibacterial medication. When antibacterial drugs are needed, the principle of using a drug with the narrowest spectrum has long been held and is clearly outlined in recent guidelines.1 Studies have shown that 85% of oral bacteria are susceptible to penicillin V. This is only marginally higher – 91% – with amoxycillin.2 Over 10% of Australian Streptococcus pneumoniae isolates have reduced susceptibility to penicillins, yet these isolates paradoxically remain susceptible to higher doses of oral amoxycillin. Potentially life-threatening S. pneumoniae infections in children can be effectively treated with high-dose amoxycillin and this is one of the clinical reasons why amoxycillin is not recommended as the first drug of choice for oral infections.1 Dentists should be aware of changing drug-resistance patterns and use antibiotics judiciously.


Michael McCullough

Chair, Therapeutics Committee, Australian Dental Association