Rational Antibiotic Use in Adolescent Dental Care: Pharmacology, Clinical Evidence, and Stewardship—A Narrative Review
Keywords:
Adolescent; Dentistry; Anti-Bacterial Agents; Antimicrobial Stewardship; Drug Resistance, Bacterial.Abstract
Objective. To review when systemic antibiotics are appropriate in adolescent dental care and the implications for pharmacological selection, prevention of complications and antimicrobial stewardship.
Data sources. A narrative review of literature described as searched in PubMed, Embase, Cochrane Library, LILACS, SciELO and Google Scholar for January 2000–September 2026, supplemented by professional guidance.
Data synthesis. Localised pulpitis and odontogenic infections usually require dental source control rather than systemic antibiotics. Guidance for children and adolescents supports antibiotics when infection spreads or systemic features develop. Extraction prophylaxis may reduce infection, but its routine use in otherwise healthy patients has uncertain net value. Selected high-risk cardiac patients may require prophylaxis for invasive procedures. Evidence for audit and feedback is promising but comes chiefly from broader primary-care populations.
Conclusion. Adolescent dental stewardship should combine timely dental treatment, careful assessment of allergy and body weight, conservative antibiotic selection and patient-centred counselling. More studies reporting outcomes separately for adolescents are needed.
