THE RISKS OF DENTAL EXTRACTION DURING PENICILLIN TREATMENT

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Abstract
During treatment with penicillin, the normal streptococci in the mouth are suppressed and replaced by penicillin-resistant strains. One patient suffered a 2d attack of bacterial endocarditis due to a highly resistant streptococcus following dental extractions carried out several days after prophylactic administration of penicillin had been started. The other patient relapsed with infection due to a penicillin- and streptomycin-resistant Streptococcus after dental extractions carried out during a course of treatment with these 2 antibiotics. Penicillin "cover" for dental extractions should be begun immediately before the operation. Dental treatment for a patient with bacterial endocarditis should be carried out before penicillin treatment is begun. Should extractions be indicated during this treatment they may be covered with a different antibiotic.