Rational antibiotic therapy in dentistry: a key step against antimicrobial resistance

Aim: The aim of this study is to analyze the misuse of antibiotics in dental practice and to identify effective public health strategies for rational use, in order to prevent antimicrobial resistance (AMR) and improve oral health. Material and Methods: An analysis was conducted of relevant domestic and international literature, professional guidelines, and protocols related to antibiotic therapy in dentistry. Additionally, data were reviewed concerning the most common clinical indications for antibiotic prescription, including acute and chronic infections as well as cases of prophylactic use. As part of the research, data from the Institute of Public Health of the Republic of North Macedonia were included, with a special focus on analyses conducted in the laboratories of the Microbiology Department. Through these laboratory analyses, patterns of antimicrobial resistance in isolates associated with oral infections were monitored, as well as their susceptibility to the most commonly used antibiotics. A comparative analysis was made between rational and irrational use of antibiotics and the consequences thereof. Results: The use of antibiotics in dentistry is often based on an empirical approach without microbiological confirmation and outside of standard indications. The main factors contributing to irrational prescribing include insufficient awareness, lack of standardized protocols, patient influence, and limited clinical oversight. The implementation of public health strategies-such as continuous education, clinical guidelines, and prescription monitoring—has shown positive results in improving practices and reducing unnecessary use. Conclusions: Dentists play a key role in preventing antimicrobial resistance through rational and evidence based antibiotic prescribing. Integration of dental practice into national AMR control strategies, development of local clinical protocols, and ongoing professional education are necessary. This ensures safe and effective therapy for oral infections while minimizing the risk of resistant pathogens.