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Antibiotics Not Routine Perio — ORE Part 1 MCQ

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ModeratePeriodontologyAntibiotics Not Routine PerioORE Part 1

A 35-year-old patient has generalized Stage III Grade B periodontitis. They do not smoke and have well-controlled diabetes (HbA1c 48 mmol/mol). Following oral-hygiene intervention, the patient is about to undergo Step 2 subgingival instrumentation. According to BSP-S3 guidance, what is the most appropriate approach to adjunctive systemic antibiotics?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Do not prescribe them routinely; continue non-surgical periodontal therapy.

Explanation lettering: D = shown as B · B = shown as C · E = shown as D · C = shown as E

A is correct. UK BSP-S3 implementation guidance advises against routine adjunctive systemic antibiotics for periodontitis, including during non-surgical treatment. This patient has Grade B disease, does not smoke, and has controlled diabetes; these facts do not establish the high-susceptibility situation in which specialist or advanced-care assessment may be considered. Amoxicillin-metronidazole, doxycycline and azithromycin are not routine prescriptions based solely on Stage III disease or diabetes. Option E is also wrong because systemic antibiotics are not absolutely prohibited: selected patients, for example younger adults with documented rapidly progressive Grade C disease and inadequate response to non-surgical therapy, may warrant specialist-led consideration.

Reference: Scottish Dental Clinical Effectiveness Programme. Prevention and Treatment of Periodontal Diseases: Antimicrobial medication, systemic antibiotics section, accessed 24 July 2026. https://www.periodontalcare.sdcep.org.uk/guidance/treatment-components/pmpr/antimicrobial-medication/