The routine use of antibacterial agents for the management of odontogenic infections has not been shown to be effective and is inappropriate. Most of these bacterial infections can be resolved satisfactorily through an approach that incorporates debridement (primary dental care) in conjunction with local anesthesia. Odontogenic infections are polymicrobial. Facultative anaerobes, particularly viridans streptococci, accompanied by strict anaerobes, appear to predominate in all types of odontogenic infections. When antibacterial chemotherapy is indicated, the drug of choice should be either the most effective drug against the infective pathogens or the least toxic alternative among several available agents. It should also be emphasized that drugs seldom exert their beneficial effects without also causing adverse side effects. Dealing with this certainty, the clinician familiar with the mechanisms of action, principles of disposition, and therapeutic and adverse effects of antibacterial agents, has the advantage.
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