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. Rapidly Progessing Grade C periodontitis
  1. Doxycycline (200mg loading dose + 100mg ODS for 14 days)
2. VERY SEVERE
  1. Combination of metronidazole & amoxicillin
3. 1st Line
  1. 1. Metronidazole TABLETS 400mg TDS for 3 days (can be up to 5 days)
  2. 2. Amoxicillin CAPSULES 500mg TDS for 5 days
4. 2nd Line
  1. Azithromycin 500mg ODS for 3 days
    1. Can consider Doxycycline (200mg loading dose + 100mg ODS for 14 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 about 4 years ago

	Copied by sanna pathy about 4 years ago