Toepassing van antibiotica in de parodontologie
DOI: 10.5177/ntvt.2019.10.19064 Bladzijden: 533-539
Met mechanische reiniging lukt het nooit om alle bacteriën van het tandoppervlak te verwijderen, zoals in furcaties en op de pocketbodem. Daarom kan ondersteuning van de niet-chirurgische parodontale behandeling met antibiotica een voor de hand liggende benadering zijn om een beter behandelresultaat te krijgen. De combinatie van amoxicilline en metronidazol is als ondersteuning van de parodontale behandeling uitgebreid onderzocht en verdient zeker een plaats in de rij middelen die tandheelkundige zorgverleners ter beschikking staan. De indicatie voor al dan niet voorschrijven is niet klip en klaar en derhalve dient de regie hiervoor in het kader van verantwoord antibioticagebruik (antimicrobial stewardship) in handen te zijn van degene die de receptuurbevoegdheid draagt. Additioneel 2 maal daags spoelen met chloorhexidine gedurende een parodontale behandeling en de 2 weken erna (6-8 weken) is te overwegen om klinisch nog een extra effect te bereiken.
Use of antimicrobial agents in periodontology
With mechanical cleaning, it is never possible to remove all bacteria from tooth surfaces, in, for example, furcation sites and at the bottom of the pocket. Supporting non-surgical periodontal treatment with the use of antimicrobial agents is, therefore, an obvious approach in order to achieve a better treatment outcome.. The combination of amoxicillin and metronidazole has been thoroughly investigated as a support in periodontal treatment and deserves a place among the tools the dental care professional has for effective treatment. However, there is at present no strict indication in which clinical situations antibiotics can be successfully prescribed. Considering responsible use of antimicrobials by healthcare professionals (antimicrobial stewardship) the decision to support periodontal treatment with antibiotics should be in the hands of those authorised to provide a prescription. Additional rinsing with chlorhexidine twice daily during periodontal treatment and the subsequent two weeks (6-8 weeks) can be considered in order to enhance the effect of clinical treatment.
Use of antimicrobial agents in periodontology
With mechanical cleaning, it is never possible to remove all bacteria from tooth surfaces, in, for example, furcation sites and at the bottom of the pocket. Supporting non-surgical periodontal treatment with the use of antimicrobial agents is, therefore, an obvious approach in order to achieve a better treatment outcome.. The combination of amoxicillin and metronidazole has been thoroughly investigated as a support in periodontal treatment and deserves a place among the tools the dental care professional has for effective treatment. However, there is at present no strict indication in which clinical situations antibiotics can be successfully prescribed. Considering responsible use of antimicrobials by healthcare professionals (antimicrobial stewardship) the decision to support periodontal treatment with antibiotics should be in the hands of those authorised to provide a prescription. Additional rinsing with chlorhexidine twice daily during periodontal treatment and the subsequent two weeks (6-8 weeks) can be considered in order to enhance the effect of clinical treatment.