Antibiotics in Periodontal Treatment — ORE Part 1 MCQ
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Correct answer: D — Avoid routine use; consider specialist-led use in selected high-susceptibility cases
Explanation lettering: B = shown as A · E = shown as B · A = shown as D · D = shown as E
A is correct. UK SDCEP guidance strongly advises against routine adjunctive systemic antibiotics for periodontitis, despite evidence of potential clinical benefit, because stewardship, adverse effects and generalisability to primary care must be considered. In selected high-susceptibility cases, such as a younger patient with Grade C disease and poor response to non-surgical treatment, referral for specialist or advanced-care-practitioner assessment of adjunctive antibiotics may be appropriate. B is wrong because Stage III alone does not justify routine antibiotics. C, D and E are wrong because UK guidance does not endorse metronidazole, amoxicillin or doxycycline monotherapy as a universal or standard first-line adjunct. The discriminating feature is selective, specialist-led use rather than automatic prescribing.
Reference: Scottish Dental Clinical Effectiveness Programme. Prevention and Treatment of Periodontal Diseases in Primary Care: Antimicrobial medication, current web guidance. https://www.periodontalcare.sdcep.org.uk/guidance/treatment-components/pmpr/antimicrobial-medication/