Rational Use of Antibiotics in Endodontics - Brazilian Endodontic Society Guideline
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Published in Vol. 6 No. 1 (2026) of Brazilian Endodontic Journal.
About the JournalAbstract
Antimicrobial resistance is one of the major challenges facing global public health, and Dentistry accounts for a substantial share of antibiotic prescriptions, many of which lack an appropriate clinical indication. Most endodontic infections remain confined to the root canal system and the periapical tissues and are controlled by local procedures, so that systemic antibiotics rarely constitute the primary therapy. This guideline, developed by the Brazilian Endodontic Society (SBEndo), provides evidence-based recommendations for the rational use of antibiotics in Endodontics. It defines the clinical situations in which systemic antibiotics are indicated as adjunctive therapy (acute apical abscess with systemic involvement, progressive infections, immunocompromised patients, replantation of avulsed permanent teeth, extensive soft tissue trauma and selected persistent infections) and those in which they are not indicated. It also establishes recommendations on the choice of antimicrobial, with amoxicillin as the first-choice agent, alternatives for penicillin-allergic patients, the role of microbiological culture, the duration of treatment guided by clinical progress, and the indications for antibiotic prophylaxis according to current cardiology recommendations. In all situations, antibiotics are regarded exclusively as adjunctive therapy, and elimination of the source of infection through endodontic treatment, drainage or other local interventions remains the main determinant of therapeutic success.
References
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Copyright (c) 2026 Emmanuel Silva, Leandro Pereira, Daniel Decurcio
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