It is estimated that about 10% of the total number of prescribed antibiotics are prescribed by dentists. They are most often used for the prevention of odontogenic infections or as an antibacterial therapy (1, 2). There are strict guidelines on the use of antibiotics in paediatric dentistry. According to the American Academy of Pediatric Dentistry (AAPD), these include traumatic oral injuries with the risk of contamination with extraneous bacteria, mandibular and/or maxillary fractures, temporomandibular injuries, total luxation of a permanent tooth, odontogenic infection with systemic symptoms, aggressive periodontitis, necrotizing ulcerative gingivitis or periodontitis, bacterial parotitis and bacterial inflammation of the submandibular gland (3).

According to the recommendations of the European Academy of Paediatric Dentistry (EAPD), systemic antibiotic therapy is used in acute infections, diffuse inflammation with pain (moderate to severe) or fever, infections spreading outside the oral cavity, bone and bone marrow inflammation, major soft tissue trauma, alveolar bone fracture, following tooth reimplantation, in localised aggressive periodontitis and most infections, regardless of the course and severity in patients with systemic diseases (4). Systemic antibiotics are not indicated in healthy children with locally limited infection in the absence of fever or facial oedema, and when the cause of infection can be eliminated (5, 6). Amoxicillin or ampicillin is recommended as standard prophylaxis, while clindamycin should be used in patients allergic to both these antibiotics. Cephalexin, cefazolin and ceftriaxone are alternatives to penicillin. However, cefalosporins should not be used in patients with a history of anaphylactic reaction, vascular oedema or urticaria following the administration of penicillin or ampicillin (4, 6). The risk of developing bacterial resistance to currently available antibiotics has become more common. The percentage of K. pneumonia and E. coli with simultaneous resistance to fluoroquinolones, third generation cephalosporins and aminoglycosides has increased significantly over the last four years (2011-2014) in the European Economic Area (EEA). An increase in the weighted average in the percentage of K. pneumonie resistance to carbapenems, an important class of last-line agents used in the treatment of infections caused by multiresistant gram-negative rods, for the EEA population is a serious threat for the safety of patients (7). Therefore, it is essential to adhere to the principles of antibiotic therapy as well as to limit the use of antibiotics to situations when these agents are absolutely necessary.

The aim of the study was to determine clinical situations in which a decision was made to use systemic antibiotics, as well as the time of administration and the type antibiotics used.

We performed a retrospective analysis of medical records of 5,100 patients treated between 2013 and 2015 in the Department of Paediatric Dentistry at the Medical University of Warsaw.

We searched for data related to the physician prescribing antibiotics, the reasons for systemic antibiotic therapy (oral inflammation and trauma) and antibiotic prophylaxis prior to surgeries involving the risk of bacteremia (a systemic disease). In the case of antibiotic therapy in traumatic patients, the type and the extent of injury was recorded. Also, data on therapy duration, the type of antibiotic used (whether it was mono- or polytherapy) and the recommended doses were analysed.