Antiinfective Drugs

Bacteriocidal
1. Drugs that interfere with the cell wall
  1. Penecillins, cephalosporins, bacitracin
    1. Penicillins
      1. Gram + cocci
        Penicillinase resistant: enzyme produced by staphylococci making it microbe resistant.
      2. Extended spectrum g+/-: e coli, H influenzae, proteus mirabilis
        ampicillin, amoxocillin: claculanic acid is penicillinase resistant.
    2. Cephalosporins: spectrum varies w each generation + to more -
      1. 10% cross hypersensitivity w penicillin
2. Drugs that interfere with the cell membrane
  1. antifungals: nystatin, ketoconazole, clotrimazole
Bacteriostatic
1. drugs that interfere with protein synthesis:
  1. metronidazole, tetracyclines, clindamycin, erythromycin
    1. Tetracyclines: broad spectrum (gram +/-)
      1. bind to calcium: bad for pregnat/breastfeeding women
      2. ADR: GI upset, stomatitis, superinfection, photosensitivity, enamel hypoplasia,tooth staining
    2. Macrolides: gram + microbes
      1. used in ppl w penicillin allergies (clarithromycin & azithromycin common in dentistry)
      2. ADR: GI upset , stomatitis, candidiasis
      3. Interactions: eryth: bronchodialator (inc theophylline levels), inc. warfarin effect, dec. Birth control pill effect
    3. Metronidazole: inhibits PRO synthesis (not normal)
      1. perio anaerobic infections: NUG/NUP
        avoid alcohol (food, drink, rinses)
Antifolates
1. drugs that interfere with nucleic acid synthesis
  1. sulfa, quinalones (ciprofloxacin & norfloxacin), & antiTB drugs (rifampin & isoniazid)
    1. Fluoroquinolones: affect bacterial DNA
    2. avoid elecive dental Tx if TB+
    3. Dr consult to confirm liver function

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Antiinfective Drugs

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