ORAL

Question 1

Are penicillins effective in oral infections?

Answer 1

• Pen V is effective for dentoalveolar abscess
• Amoxicillin is as effective, but better absorbed
• Amoxicillin is a broad spectrum = can cause resistance
• Pen V and A ineffective against becta lactamase
• Co-amoxiclav is used against beta lactamase producing bacteria

Question 2

Are Cephalosporins effective in dental/oral infections?

Answer 2

• They offer little advantage over penicillins
• They are less active against anaerobes
• Infections due to oral streptococci that are resistant to penicillins tend to be resistant to cephalopsorins

Question 3

Are Tetracyclines effective in oral infections?

Answer 3

• Effective against oral anaerobes
• Development of resistance has reduced their usefullness
• Doxy preferred

Question 4

Are Macrolides effective in oral infections?

Answer 4

• Macrolides are an alternative for oral infections in penicillin-allergic patients or where a beta-lactamase producing organism is involved
• However, many organisms are now resistant to Macrolides and therefore they should only be given for a short course

Question 5

Is Clindamycin effective in oral infections?

Answer 5

• They should NOT routinely be used for treatment of oral infections
• Its no more effective than penicillin against anerobes
• There may be cross-
  resistance with erythromycin-resistant bacteria

Question 6

Is Metronidazole (and
Tinidazole) effective in oral infections?

Answer 6

-penicillin-allergic or infection due to beta-
lactamase producing organisms
- Metronidazole is first line for acute necrotising ulcerative gingivitis (Vincent’s infection)
- Metronidazole for 3 days is often sufficient (can be for 5 days)
- Tinidazole is also licensed for the treatment of acute ulcerative gingivitis