Antibiotics

Antibiotics

Cell wall interference
1. MoA = inhibit cross-linking of peptide chains
2. Penicillin
  1. Amoxicillin
    1. Broad spectrum
    2. Use
      1. Dento-alveolar infections (with SF/SI)
      2. Bacterial sinusitis
      3. Prophylaxis (3g, 1hr before)
      4. After re-implantation of avulsed tooth
      5. Rapidly progressing Grade C or Unresponsive perio
        2nd choice
    3. 500mg, 3xday, 5 days
  2. Flucloxacillin
    1. Beta lactamase resistant
    2. Use
      1. Soft tissue infections
        Impetigo
      2. Acute bacterial sialadenitis
    3. Staph. A
  3. Co-Amoxiclav
    1. = Amoxicillin + Clavulanic acid
    2. Broad spectrum + Beta lactamase resistant
    3. Use
      1. 2nd line for dento-alveolar infections
      2. Severe dento-alveolar infection with spreading cellulitis
        Ludwig's Angina
3. Vancomycin
4. Bacitracin
Inhibit protein synthesis
1. Tetracylines
  1. Doxycline
    1. Broad spectrum
    2. Anaerobes
    3. Use
      1. Rapidly progressing Grade C or Unresponsive perio
        If Penicillin allergy
        200mg loading dose + 100mg, 1xday, up to 14 days
  2. Minocycline
  3. MoA = inhibit binding of tRNA at 30S
2. Gentamycin
  1. MoA = inhibits reading of mRNA at 30S
3. Macrolides
  1. MoA = inhibition of translocation at 50S
    1. Lincosamides
  2. Clarithromycin
    1. Broad spectrum
    2. Beta-lactamase-producing bacteria
    3. Use
      1. 2nd line for dentoalveolar infections
      2. Severe dento-alveolar infection with spreading cellulitis
  3. Erythromycin
  4. Azithromycin
    1. Gram+ve
    2. Use
      1. Rapidly progressing Grade C or Unresponsive perio
        2nd line
        500mg, 1xday, 3 days
4. Chloramphenicol
  1. MoA = inhibition of transpeptidase (50S)
5. Lincosamide
  1. Clindamycin
    1. Broad spectrum
    2. Gram+ve inc. strep. & penicillin-resistant staph.
    3. Use
      1. 2nd line for dento-alveolar infections
        1st choice
      2. Severe dento-alveolar infection with spreading cellulitis
        Ludwig's angina
      3. Osteomyelitis
    4. Anaerobes
    5. 150-300mg, 4xday, 7 days
Interfere with Nucleic acids
1. Metronidazole
  1. Anaerobes
  2. Broad spectrum
  3. MoA = inhibits DNA replication
  4. Use
    1. Allergy to penicillin
      1. Dentoalveolar infection with SF/SI
      2. 400mg, 3xday, 5 days
    2. Periodontal abscess with SF/SI
      1. 400mg, 3xday, 3 days
    3. NUG
    4. Pericoronitis with SF/SI
    5. Rapidly progressing Grade C or Unresponsive perio
      1. 1st choice
      2. 400mg, 3xday, up to 5 days
2. Sulfonamides
  1. MoA = inhibits DNA production
3. Trimethoprim
4. Rifampicin
  1. MoA = inhibits RNA synthesis
  2. Avoid with contraceptive pill

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