The use of antibiotics in the management of odontogenic facial swellings in children and adolescents: A scoping review.

作者信息

Welti Rachelle, Ravindra Dharini, Teoh Leanne, Sloan Alastair, Burgner David, Silva Mihiri

机构信息

Melbourne Dental School, Faculty of Medicine, Dental and Health Sciences, The University of Melbourne, Australia; Inflammatory Origins, Murdoch Children's Research Institute, The Royal Children's Hospital, Australia; Department of Dentistry, The Royal Children's Hospital Melbourne, Australia.

出版信息

J Dent. 2025 Feb;153:105523. doi: 10.1016/j.jdent.2024.105523. Epub 2024 Dec 20.

OBJECTIVES

To identify evidence and guidelines relating to the use of antibiotics in the management of odontogenic facial swellings in children and adolescents.

DATA

Articles relating to odontogenic facial swellings in children and adolescents aged 0-16 years were included. Articles in which paediatric data could not be differentiated from adult data or where the age of participants were unknown were excluded. Also excluded were guidelines that did not provide age-specific recommendations. Resources that exclusively focused on localised odontogenic infections, Ludwig's Angina, neck infections, orbital cellulitis and sepsis and those that pooled data related to odontogenic facial swelling and other medical or dental conditions were excluded.

SOURCES

MEDLINE, PubMed and EMBASE were searched with no date restrictions. Google Advanced Search was used to identify grey literature.

STUDY SELECTION

Of the 5251 identified articles, 22 primary studies and 32 secondary sources of evidence were included after full text review. No articles evaluated the use of specific diagnostic criteria used to support antibiotic prescribing. Three studies evaluated the effectiveness of antibiotic regimes in the management of odontogenic facial swellings in young people. Antibiotic regimes varied; oral amoxicillin was the most frequently recommended first-line therapy, followed by phenoxymethylpenicillin. Most articles recommended antibiotics as an adjunct to dental treatment. The weight of the child, penicillin allergy/ hypersensitivity and clinical response to therapy were commonly reported to influence antibiotic prescribing. Inconsistencies between guidelines were identified which is likely due to a lack of evidence regarding the use of antibiotics in the paediatric population.

CONCLUSIONS

High quality, robust research with clearly defined outcome measures and thorough reporting is required to develop comprehensive, evidence-based guidelines for children and adolescents with odontogenic facial swellings.

CLINICAL RELEVANCE

This paper allows clinicians to compare guideline recommendations, understand the context of these guidelines and review local practices.