Antibiotic Prophylaxis for the Endodontic Patient 

I personally prefer it this way. The speech is clear without tiring unnecessary pauses, just straight to the point.

Rekha Yesudas to ensure (brief and ephemeral yet profuse concentration well above mic) antibiotic accumulation at surgical site during the procedure so to combat any potential contaminant at frontline

+Ashwaq Amiri Only if the patient is severely immune compromised. We will do more videos on the medically compromised patient soon. Cheers!

The root canal therapy itself is the best antibiotic. THere's no need for antibiotic treatment in a patient unless the patient has a fever as a result of the infection or is severely immune compromised. Taking Antibiotics can be much more harmful than helpful in the average patient and are best avoided unless absolutely necessary.

Real World Endo thank you very much,you cleared a big misconception among dentists tht n all periapical infection cases during rct antibiotics course is necessary

hi sir... i have seen such things but no matter from which direction the micro organism enter the pulp chamber it is going to take its course entirely through the pulp in such case the possibility of periapical lesion on the opposite side or any other direction is self explanatory... thank you...

I must say I have not observed the same correlation. But maybe it's because I haven't paid attention to this. I will try to keep an eye open! Cheers! :)

..

Only after a thorough consultation and documented clearance by the patient's cardiologist/physician. Or at least that's the prudent mode to move forward. Many would just go ahead and do it and most likely will be fine. It's a question of one's personality and style to mitigate these risks.

Hutham H The prophy course is directed at microbes that tends to cause Subacute Bacterial Endocarditis as well as create infective vegetations. These bacteria are not anaerobic and therefore not the main target of prophylaxis.

That's completely an overkill and not necessary. I never do that and the cases work well too. So, obviously it's not related to that recipe.

UMESH G The dose is the same as what hey would take before the procedure. Basically, studies show that you can ideally take the prophylaxis regimen one hour before the procedure or up to two hours after the procedure. Hope this helps. :)

thank you sir... your reply means a lot to me ...

UMESH G Cheers! :)

You have to be more specific than that. There could be many reasons. But they clearly feel pain because there's inflammation at the apex. The cause of inflammation is dependent on the situation and how long after they still feel the pain to chewing. If it's more than one month it's likely due to incomplete cleaning and shaping and remaining biofilm at the apex.

Usually best to start with Pen VK 500mg. However, these are regional and the microbiology differs slightly from location to location. I always go with Pen VK 500 QID and if it doesn't respond I either add Metronidezol 250mg QID or switch to Amox with Calvuronic Acid (500mg QID). I may also go for Clindamycin 150mg QID with a loading dose of 300. Also, these all depend on the patient weight and severity of infection.

Real World Endo Is there a difference if the patient are medically compromised or not?

Depends what you mean by medically compromised. If the patient is an AIDS patient and has no remaining immune system, then yes, give them coverage if they have a necrotic tooth with an abscess; but if they're medically compromised because they have a heart problem or high blood pressure then no!

Real World Endo If patient has an abscess ..then it is a treatment not a prophylaxis any more isn't it ? so if I have to increase dose or use a specific combination for people at higher risk like categories mentioned in the video or AIDS patient as you mention in the comment?

I'm sorry I thought you were talking about post treatment antibiotics, not prophylaxis. I think the topic of prophylaxis is adequately addressed in the video I was referring to post treatment antibiotics here. I think I will delete my comments here to avoid confusion for people since those doses are only used for post treatment, not prophylaxis. I would not treat anyone with prophylaxis unless they have the indications made in this video. Everyone else the questions is whether they should get post operative prophylaxis.

Completely unnecessary and over prescription of antibiotics. Antibiotics are only recommended if patient has a fever, is immune compromised, or has cellulitis. Otherwise, root canal therapy itself is the best antibiotic!