Should Antibiotics Be Rationed in Periodontics—if Yes, how?

  • Andrea MombelliEmail author
Clinical Periodontics (Y Stathopoulou, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Clinical Periodontics



Based on the latest findings, we evaluate the benefits and risks of systemic antibiotics in periodontal treatment and search for opportunities to reduce their use.

Recent Findings

Thorough mechanical debridement by deep scaling and root planing (SRP) resolves a considerable amount of pathology on its own. Thus, antibiotics are not needed for most cases of periodontitis. Specific indications are the presence of multiple deep pockets, especially in the molar area and rapid rate of progression. There, SRP plus amoxicillin-metronidazole can be an efficacious, minimally invasive, rapid, and inexpensive form of treatment. Considering recent findings on benefits and unwanted effects of antibiotics, we present three scenarios to limit or optimize their use.


Antibiotics are no alternative for high-quality SRP or oral hygiene. Antibiotics adjunctive to SRP should be weighed on an individual basis against the necessity of further therapy at a later stage.


Antibiotics Periodontal therapy Rationing Decision-making 



The author expresses his gratitude to Doctor Stefan Harbarth, Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, Switzerland, for reviewing the manuscript and helpful suggestions. Dr. Philipp Wick treated the case depicted in Fig. 1 during his postgraduate training at the University of Geneva School of Dental Medicine.

Funding Information

The author’s work on antimicrobial therapy as adjunct to periodontal treatment was supported by the Swiss National Science Foundation, Grant No. 320030-122089.

Compliance with Ethical Standards

Conflict of Interest

Dr. Mombelli reports a grant from Swiss National Science Foundation and non-financial support from Institute for Applied Immunology during the conduct of the study.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Authors and Affiliations

  1. 1.University Clinic of Dental Medicine Division of PeriodontologyUniversity of GenevaGeneva 4Switzerland

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