Use of Antibiotics in Endodontics 2010

Objectives and Goals

  • The students will be able to describe the indications and contra-indications for the use of antibiotics for the treatment of infections of endodontic origin.
  • The students will be able to describe a hierarchy of antibiotics for the treatment of infections of endodontic origin.
  • The students will be able to discuss minimum inhibitory concentration (MIC) of antibiotics and how to achieve MIC in patients.
  • The students will be able to describe the indications for the use of prophylactic antibiotics as recommended by the American Heart Association.

Abstracts should include: title, authors, purpose, M&M, results, author's conclusions, & your conclusions. - Critically evaluate the findings.

All read:

Prevention of Bacterial Endocarditis (AHA Guidelines 2008) JADA 2008;139(Jan):3s-24s.

Antibiotic prophylaxis for dental patients with total joint replacements. JADA 2003;134(July):895-899

Antibiotics Anonymous

Pathways of the Pulp 9th ed. pp. 596-599.


Heimdahl A, von Konow L, Nord CE. Treatment of orofacial infections of odontogenic origin. Scand J Infect Dis, Suppl. 46:101-105, 1985.

Hersh EV. Adverse drug interactions in dental practice. JADA 1999;130(2):236-251.

Alexander R. Routine prophylactic antibiotic use in diabetic dental patients. CDA 1999;27(8):611-618.

Lockhart PB, Loven B, Brennan MT, Fox PC. The evidence base for the efficacy of antibiotic prophylaxis in dental practice. J Am Dent Assoc. 2007 Apr;138(4):458-74

Do antibiotics reduce flare-ups?

Mata E, Koren LZ, Morse DR, Sinai IH. Prophylactic use of penicillin V in teeth with necrotic pulps and asymptomatic periapical radiolucencies. Oral Surg 1985;60(2):201-207.

Walton RE, Chiappinelli J. Prophylactic penicillin: effect on posttreatment symptoms following root canal treatment of asymptomatic periapical pathosis. J Endod 1993;19(9):466-470.

Fouad AF, Rivera EM, Walton RE. Penicillin as a supplement in resolving the localized acute apical abscess. Oral Surg 1996;81(5):590-595.

Nagle D, Reader A, Beck M, Weaver J. Effect of systemic penicillin on pain in untreated irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:636-40.

Pickenpaugh L, Reader A, Beck M, Meyers WJ, Peterson LJ. Effect of prophylactic amoxicillin on endodontic flare-up in asymptomatic, necrotic teeth. J Endod 2001;27(1):53-56.

Henry M, Reader A, Beck M. Effect of penicillin on postoperative endodontic pain and swelling in symptomatic necrotic teeth. J Endod 2001;27(2):117-123.

Lindeboom JAH, Frenken JWH, Valkenburg P, vandenAkker HP. The role of preoperative prophylactic antibiotic administration in periapical endodontic surgery: a randomized, prospective double-blind placebo-controlled study. Int Endod J. 2005;38:877-81.

Susceptibility of clinical isolates

Barnard D, Davies J, Figdor D. Susceptibility of Actinomyces israelii  to antibiotics, sodium hypochlorite and calcium hydroxide. Int Endod J 1996;29:320-326.

Khemaleelakul S, Baumgartner JC, Pruksakorn S. Identification of bacteria in acute endodontic infections and their antimicrobial susceptibility. Oral Surg Oral Med Oral Pathol 2002;94(6):746-55.

Baumgartner JC, Xia T. Antibiotic susceptibility of bacteria associated with endodontic abscesses. J Endod 2003;29(1):44-47.

Jacinto RC, Montagner F, Signoretti FG, Almeida GC, Gomes BP. Frequency, microbial interactions, and antimicrobial susceptibility of Fusobacterium nucleatum and Fusobacterium necrophorum isolated from primary endodontic infections. J Endod. 2008 Dec;34(12):1451-6.


Norrington DW, Ruby J, Beck P, Eleazer PD. Observations of biofilm growth on human dentin and potential destruction after exposure to antibiotics. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Apr;105(4):526-9.

Sedgley CM, Lee EH, Martin MJ, Flannagan SE. Antibiotic resistance gene transfer between Streptococcus gordonii and Enterococcus faecalis in root canals of teeth ex vivo. J Endod 2008 May;34(5):570-4.

Current trends

Yingling NM, Byrne BE, Hartwell GR. Antiobiotic use by members of the American Association of Endodontists in the year 2000: report of a national survey. J Endod 2002;28(5):396-404.

Lee M, Winkler J, Hartwell G, Stewart J, Caine R. Current trends in endodontic practice: emergency treatments and technological armamentarium. J Endod. 2009 Jan;35(1):35-9.