1. First-line thinking — check the current table

This module

This is module 2 of 2 (1 hour). Completing both is the full 2-hour antimicrobial stewardship series.

Suggested study time

• Choice, dose and duration from current guidance — 20 min
• Allergy, interactions and delayed scripts — 18 min
• The record and the review — 17 min
• Knowledge check — 5 min

Do not prescribe from a faded poster

First-line agents for odontogenic infection, penicillin-allergy alternatives, and whether metronidazole is added, are set in current UK dental antimicrobial guidance and the BNF. Those tables have changed more than once. This course will not freeze a drug name that may be out of date next year. Open the current source on the day.

Narrow, short, oral where possible

Use the narrowest appropriate spectrum, a duration that matches the indication (not “finish the family pack”), and oral therapy if the person can swallow and absorb. Broad “just in case” combinations are for specific clinical pictures, not for toothache after a scale.

Dose with the person in mind

Weight in children, renal impairment, pregnancy and breastfeeding change what is reasonable. Check. Do not copy an adult capsule onto a five-year-old.

Hospital and OMFS

Spreading floor-of-mouth infection, airway risk, or a deteriorating patient is not a stewardship win because you avoided a drug — it is an urgent referral (see Sepsis Awareness). Stewardship includes escalating when infection is beyond primary care.