Restrictions regarding the use of antibiotics make selective antibiotic dry cow therapy (DCT) mandatory on organic farms in Germany. This requires methods for identifying cows with an intramammary infection (IMI) at dry-off. The aim of this field study was to create a decision scheme for the use of DCT based on cow level factors associated with IMI at dry-off and the probability of both cure and new infection (NI) during the dry period. Data from 250 cows from five organic farms were collected including somatic cell counts (SCC) from Dairy Herd Improvement (DHI) records, California mastitis test (CMT) results at dry-off, clinical mastitis (CM) history, parity and dry-off treatment. IMI at dry-off were most accurate identified using a geometric mean SCC of 100 000 cells/ml as a threshold at either one or three DHI records prior to dry-off. Using a combination of SCC with either CM history, CMT at dry off or parity slightly increased the sensitivity of detection (SE). The probability of cure of the infection over the dry period increased with use of both antibiotic DCT and application of an internal teat sealant (ITS) and decreased when the dry period was longer than 56 d. The risk of NI decreased with the use of ITS and infections with minor pathogens at dry-off. Compared with the selection performed by the farmers during the study period identification of IMI based on the selection criterion with a defined SCC threshold achieved a higher SE.