Table 1.

Considerations for antimicrobial therapy36

Indicated clinical conditions for antibiotic therapy	Nonindicated clinical conditions for antibiotic therapy
1. Pyrexia within last 24 h-indicates a systemic response to the infection	1. Pain-(analgesics/antiinflammatory drugs are indicated)
2. Systemic symptoms like malaise, fatigue, weakness, dizziness, rapid respiration and local tender lymphadenopathy-indicate an impending sepsis	2. Edema-(antiinflammatory drugs indicated)
3. Trismus-indicates spread to peri mandibular spaces and can extend to secondary spaces that can be potentially dangerous. Also, trismus makes intraoral procedures difficult, which must wait until the trismus is relieved.	3. Redness/heat-(antiinflammatory drugs indicated)
4. As a prophylaxis in patients with systemic conditions like rheumatic heart disease, endocarditis, heart/orthopaedic prosthesis	4. Purulence-(resolved by drainage of pus/debridement)
5. In patients with any kind of immunocompromise-AIDS, cancer, autoimmune diseases, corticosteroid therapy, patients with immune-compromised diseases like cyclic neutropenia, pancytopenia, uncontrolled diabetes to name a few common ones.	5. Abscess-localized (e.g., alveolar abscesses, periodontal abscesses)-(Resolves by incision and drainage)
6. After solid Organ transplant/grafts (cardiac/renal/bone marrow/liver/osseous	6. Draining sinus tract. (Removal of foci of infection resolves drainage and sinus tract may heal on its own or may have to be surgically excised.)