Antimicrobials for periodontitis

Rapidly progressing Grade C disease (ONLY DISEASE YOU PRESCRIBE ABX FOR IN PRACTICE)
1. Refer urgently!
2. When rate of destruction is not consistent with local factors
  1. e.g optimal OH & no calculus
  2. You would refer this though
Prescribe for
1. Severe ANUG
2. Periodontal abscess
  1. If local measures don't work
3. Rapidly progressing Grade C disease
  1. Refer too
4. Cases that haven't responded to non-surgical management of perio
  1. Refer too
5. Not stabilised after repeated courses of RSI
  1. Refer too
Notes
1. Must be as an adjunct to RSI
2. Ideally after RSI done
3. You want RSI to be completed in 7-14 days
4. Record patient compliance in notes!!!!
What to prescribe? CHECK SDCEP
1. 1. Metronidazole TABLETS 400mg TDS for 3 days (can be upto 5)
2. 2. Amoxicillin CAPSULES 500mg TDS for 5 days
3. 3b). Penecillin allergic patient 100mg doxycycline but occasionally
4. VERY SEVERE
  1. Combination of metronidazole & amoxicillin
5. 3a) If you can't prescribe the first two for periodontal conditions is erythromycin or clarithromycin/clindomycin NOT tetracycline. 500mg once a day for 3 days
Who should i refer?
1. Rapidly progressing Grade C disease
2. MH affecting clinical management
  1. Head & neck radiotherapy
  2. IV bisphosphonates
  3. Immunocompromised
  4. Bleeding disorder
  5. Potential drug reactions
  6. Unstable diabetes
3. Any pt's that have consistent pockets >5mm with bleeding

Resource summary

	Created by Zainab Patel over 4 years ago