THERAPEUTIC APPROACH TO ODONTOGENIC INFECTIONS: THE ROLE OF ANTIBIOTIC THERAPY IN CLINICAL TREATMENT

Abstract

Introduction: Odontogenic infections are common causes of emergency dental care and can progress to severe conditions with risk of systemic dissemination. These infections result from untreated caries, periodontitis, pericoronitis, and post-dental complications. The therapeutic approach is based on the removal of the infectious focus, combined with the judicious use of antibiotic therapy. The indiscriminate use of antibiotics can lead to bacterial resistance, making rational prescription based on clinical criteria and up-to-date guidelines essential. Objective: This study aims to analyze the importance of antibiotic therapy in the treatment of odontogenic infections, addressing the criteria for its indication, the main drugs used and the guidelines for safe and effective use. Methodology: A literature review was conducted with searches in the PubMed and SciELO databases, including studies published between 1957 and 2025. DeCs/MeSH indexed descriptors related to antibiotic therapy and odontogenic infections were used. Only full articles in Portuguese or English were considered, excluding expert opinions and studies that are not available in full. Results: The primary approach in the treatment of odontogenic infections consists of removal of the cause and surgical drainage. Antibiotic therapy is guided by an antibiogram; However, in cases where there is no time to wait for the results, the empirical prescription can be adopted. Studies indicate that the prescription of antibiotics should be made for the shortest possible time based on laboratory tests showing the suppression of the infection after the surgical intervention. One analysis showed that only 12% of dentists prescribe antibiotics properly. In addition, odontogenic infections are often caused by Gram-positive cocci (65%) and Gram-negative bacilli (25%), and microbiological culture and antibiogram are essential for the correct choice of antimicrobial. Conclusion: The rational use of antibiotics in odontogenic infections is essential to ensure the efficacy of treatment and minimize microbial resistance. The therapeutic approach should prioritize the mechanical removal of the infection associated with antibiotic therapy based on well-defined clinical criteria. The antibiogram is a valuable tool for the proper selection of drugs, ensuring a more effective and safe treatment for patients.