Infection, after pain management, is the dental problem for which drugs are most often prescribed
Types of dental infections:
-Caries -Periodontal disease (Biggest problem in adult patients) -Localized dental infections -Systemic dental infections
Stages of dental infection "Evolution":
1.) Early stage- Aerobes 2.) Mixed stage- Aerobes and anaerobes 3.) Chronic stage- Anaerobes
If the infection is just beginning in the early stage, what organisms are most likely to be present?
What is the drug of choice in the early stage?
If a patient has a penicillin allergy, what alternatives may be used?
Erythromycin or clindamycin
What drug is used for anaerobic organisms?
What drug affects both gram-positive cocci and gram-positive and gram-negative anaerobes?
Substances that act against or destroy infections (may be synthetic)
Substances that destroy or suppress the growth or multiplication of bacteria (may be synthetic)
Chemical substances produced by microorganisms that have the capacity, in dilut solutions, to destroy or suppress the growth or multiplication of organisms or prevent their action
Substances that destroy or suppress the growth or multiplication of microorganisms
Substances that destroy or suppress the growth or multiplication of fungi
Substances that destroy or suppress the growth or multiplication of viruses
The ability to kill bacteria
The ability to inhibit or retard the multiplication or growth of bacteria
Blood (serum) level
Concentration of the antiinfective agent present in the blood of serum
An invasion of not only the body by pathogenic microorganisms but also a reaction of the tissues to their presence
Minimum inhibitory concentration (MIC)
Lowest concentration needed to inhibit visible growth of an organism on media after 18-24 hours of incubation Lower the MIC, Higher the potency!!
Range of activity of a drug
The spectrum of activity of an antibacterial agent may be:
-Narrow -Intermediate -Broad
Infection caused by the proliferation of microorganisms different from those causing the original infection
Superinfection is more often caused by ___ spectrum antibiotics such as ___ and increases when taken for a longer period.
Occurs when the combination of 2 antibiotics produces more effect than would be expected if their individual effects were added
Occurs when a combination of 2 agents produces less effect than either agent alone
Living or active only in the presence of oxygen
Living or active in the absence of oxygen
Factors determining likelihood of a microorganism causing an infection:
1.) Disease-producing power of the microorganism (virulence) 2.) Number of organisms present (inoculum) 3.) Resistance of the host (immunologic response)
What involves the growing of bacteria from a sample of infective exudate?
What involves the exposing of the organism to certain test antibiotics and determining whether the organism is sensitive or resistant?
Natural vs. Acquired resistance
1.) Natural- An organism has always been resistant to an antimicrobial agent because of the bacteria's normal properties 2.) Acquired- An organism that was previously sensitive to an antimicrobial agent develops resistance
The development of pseudomembranous colitis (PMC), also known as ____ ____ ___, has been a more serious consequence associated with clindamycin. It is characterized by severe, persistent diarrhea and the passage of blood and mucus.
Antibioticassociated Colitis (AAC)
What is the dose of Clindamycin?
150-300 mg q6h (qid)
Pharmacokinetics of Metronidazole
-Bactericidal -Has inflammatory effects
Adverse reactions of Metronidazole
-GI tract effects- most common adverse reaction = 12% -CNS effects -Renal toxicity -Oral effects (xerostomia, unpleasant metallic taste)
What should be avoided during Metronidazole administration and for 1 day after therapy is ceased?
Uses of Metronidazole:
1.) Medical- Useful because of its anaerobic spectrum 2.) Dental- Tx of many perio infections
Pharmacokinetics of Cephalosporins
-Bactericidal -Half-life 50-240 minutes Structurally related to the penicillins!
Adverse reactions of Cephalosporins
-GI effects- most common -Nephrotoxicity -Superinfection -Local reaction -Impair hemostasis and disulfiram-like-reaction-parenteral (injections) -Allergy
Various types of hypersensitivity reactions have been reportred in approx. ___% of patients receiving cephalosporins.
The degree of cross-hypersensitivity reported is about ___%.
Use of cephalosporins
Prophylaxis for patients with "at-risk" joints who are undergoing dental procedures likely to produce bleeding