7 antibiotic-dental

AntibioticsAntibiotics
TetracyclinesTetracyclines
QuinoloneQuinolone
ChloramphenicolChloramphenicol
MiscellaneousMiscellaneous

• Medications used to treat bacterial infectionsMedications used to treat bacterial infections
• Ideally, before beginning antibiotic therapy,Ideally, before beginning antibiotic therapy,
the suspected areas of infection should bethe suspected areas of infection should be
cultured to identify the causative organismcultured to identify the causative organism
and potential antibiotic susceptibilities.and potential antibiotic susceptibilities.

• Bactericidal: kill bacteriaBactericidal: kill bacteria
• Bacteriostatic: inhibit growth of susceptibleBacteriostatic: inhibit growth of susceptible
bacteria, rather than killing them immediately;bacteria, rather than killing them immediately;
will eventually lead to bacterial deathwill eventually lead to bacterial death

Antibiotics: TetracyclinesAntibiotics: Tetracyclines
• demeclocycline (Declomycin)demeclocycline (Declomycin)
• oxytetracyclineoxytetracycline
• tetracyclinetetracycline
• doxycycline (Doryx, Doxy-Caps, Vibramycin)doxycycline (Doryx, Doxy-Caps, Vibramycin)
• minocyclineminocycline

• Natural and semi-syntheticNatural and semi-synthetic
• Obtained from cultures of StreptomycesObtained from cultures of Streptomyces
• Bacteriostatic—inhibit bacterial growthBacteriostatic—inhibit bacterial growth
• Mechanism of actionMechanism of action
• Inhibit protein synthes by binding with 30 S-Inhibit protein synthes by binding with 30 S-
sub-unit of ribosomesub-unit of ribosome

• Bind to CaBind to Ca2+2+ and Mgand Mg2+2+ and Aland Al3+3+ ions toions to
form insoluble complexesform insoluble complexes
• Thus, dairy products, antacids, and ironThus, dairy products, antacids, and iron
salts reduce absorption of tetracyclines. Sosalts reduce absorption of tetracyclines. So
should not be given with themshould not be given with them

Tetracyclines:Tetracyclines: Therapeutic UsesTherapeutic Uses
• Wide spectrum:Wide spectrum:
– gram-negative, gram-positive, protozoa,gram-negative, gram-positive, protozoa,
Mycoplasma, Rickettsia, Chlamydia, syphilis,Mycoplasma, Rickettsia, Chlamydia, syphilis,
• Demeclocycline is also used to treat pleuralDemeclocycline is also used to treat pleural
and pericardial effusionsand pericardial effusions

Tetracyclines:Tetracyclines: Side EffectsSide Effects
Strong affinity for calciumStrong affinity for calcium
• Discoloration of permanent teeth and toothDiscoloration of permanent teeth and tooth
enamel in fetuses and childrenenamel in fetuses and children
• May retard fetal skeletal development if takenMay retard fetal skeletal development if taken
during pregnancy.during pregnancy.
• Contra-indicationContra-indication Should not be used in children &Should not be used in children &
pregnancypregnancy

Tetracyclines:Tetracyclines: Side EffectsSide Effects
Alteration in intestinal flora may result in:Alteration in intestinal flora may result in:
• Superinfection (overgrowth of nonsusceptibleSuperinfection (overgrowth of nonsusceptible
organisms such as Candida)organisms such as Candida)
• DiarrheaDiarrhea
• Pseudomembranous colitisPseudomembranous colitis

Tetracyclines:Tetracyclines: Side Effects contSide Effects cont
May also cause:May also cause:
• Vaginal moniliasisVaginal moniliasis
• Gastric upsetGastric upset
• EnterocolitisEnterocolitis
Skin rashSkin rash

Antibiotics: QuinolonesAntibiotics: Quinolones
( Floroquinolones)( Floroquinolones)
• Ciprofloxacin (Cipro)Ciprofloxacin (Cipro)
• Enoxacin (Penetrex)Enoxacin (Penetrex)
• lomefloxacin (Maxaquin)lomefloxacin (Maxaquin)
• Norfloxacin (Noroxin)Norfloxacin (Noroxin)
• Ofloxacin (Floxin)Ofloxacin (Floxin)
• LevofloxacinLevofloxacin

QuinolonesQuinolones
• Excellent oral absorptionExcellent oral absorption
• Absorption reduced by antacidsAbsorption reduced by antacids
• First oral antibiotics effective againstFirst oral antibiotics effective against
gram-negative bacteriagram-negative bacteria

Quinolones:Quinolones: Mechanism of ActionMechanism of Action
• Bactericidal by inhibiting DNA gyraseBactericidal by inhibiting DNA gyrase
• Effective against gram-negative organismsEffective against gram-negative organisms
and some gram-positive organismsand some gram-positive organisms
• Alter DNA of bacteria, causing deathAlter DNA of bacteria, causing death
• Do not affect human DNADo not affect human DNA

Quinolones:Quinolones: Therapeutic UsesTherapeutic Uses
• Lower respiratory tract infectionsLower respiratory tract infections
• Bone and joint infectionsBone and joint infections
• Infectious diarrheaInfectious diarrhea
• Urinary tract infectionsUrinary tract infections
• Skin infectionsSkin infections
• Sexually transmitted diseasesSexually transmitted diseases

Quinolones:Quinolones: Side EffectsSide Effects
Body SystemBody System EffectsEffects
CNSCNS headache, dizziness, fatigue,headache, dizziness, fatigue,
depression, restlessnessdepression, restlessness
GIGI nausea, vomiting, diarrhea,nausea, vomiting, diarrhea,
constipation, thrushconstipation, thrush

Chloramphenicol.Chloramphenicol.
• Chloramphenicol] is active against a wideChloramphenicol] is active against a wide
range ofrange of
• gram-positive and gram-negative organisms.gram-positive and gram-negative organisms.
However, because of its toxicity,However, because of its toxicity,
• its use is restricted to life-threateningits use is restricted to life-threatening
infections for which no alternativesinfections for which no alternatives
• existexist

• A. Mechanism of actionA. Mechanism of action
• The drug binds to the bacterial 50 -SThe drug binds to the bacterial 50 -S
ribosomal subunit and inhibits proteinribosomal subunit and inhibits protein
synthesissynthesis

• B. Antimicrobial spectrumB. Antimicrobial spectrum
• Chloramphenicol, a broad-spectrumChloramphenicol, a broad-spectrum
antibiotic, is active not only againstantibiotic, is active not only against
• bacteria, but also against otherbacteria, but also against other
microorganisms, such as Rickettsia.microorganisms, such as Rickettsia.
• Pseudomonas aeruginosa is not aff ected,Pseudomonas aeruginosa is not aff ected,
nor are the Chlamydiae.nor are the Chlamydiae.
• Chloramphenicol has excellent activityChloramphenicol has excellent activity
against anaerobes. The drug isagainst anaerobes. The drug is

• Side effectsSide effects
• Bone marrow depressionBone marrow depression
• Gray baby syndromeGray baby syndrome

• MiscellaneousMiscellaneous
• VancomycinVancomycin
• ClindamicinClindamicin

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