Implications for use of systemic antibiotics in clinical practice

There is some good evidence that local treatment is equal to or more effective than oral treatment. Macrolide antibiotics give better treatment results than penicillin. In general, oral antibiotics have more side-effects, especially gastrointestinal side-effects. Most studies date back 10 years or more. Resistance patterns have changed since then. Contemporary local characteristics and resistance patterns of the causative bacteria should always be taken into account when choosing treatment. When a large area is affected or when the patient has general symptoms such as fever, oral therapy seems preferable.

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