Systemic antibiotics

Question 1

Systemic chemotherapeutics have the potential to modify what two things?

Answer 1

Microbial plaque and/or host susceptibility

Question 2

What are the two clinical benefits of chemotherapeutic agents?

Answer 2

1. Antimicrobial action 2. Ability to increase host’s resistance

Question 3

Antibiotics for periodontics has the greatest benefits under what circumstances?

Answer 3

1. Presence of systemic disease 2. immunocompromised Pt 3. Aggressive perio disease 4. Pt who cannot undergo other Tx’s

Question 4

What are the four steps for using Antibiotic Tx?

Answer 4

1. Consider diagnosis and situation 2. Is it chronic perio? 3. What type of bugs are present 4. Culturing the bugs 5. Abx isn’t a monotherapy

Question 5

What kind of bug usually causes periodontitis?

Answer 5

Gram negative anaerobe

Question 6

When should you consider systemic Abx during perio therapy?

Answer 6

Aggressive periodontitis, NUP, refractory perio, immunocompromised Pts, heavy smokers, generalized severe chronic perio, w/ surgical procedures

Question 7

What are the most common systemic antibiotics used in dentistry?

Answer 7

Penicillin, Tetracyclines, Metranidazole, Clindamycin, Azithromycin (z-pack)

Question 8

Describe penicillin

Answer 8

it inhibits cell wall synthesis; narrow spectrum; bactericidal; i.e. Amoxicillin, Pen VK

Question 9

Describe tetracyclines

Answer 9

They inhibit protein synthesis; broad spectrum; bacteriostatic; concentrates in perio tissues; anticollagenase activity; i.e. doxycycline, Minocycline

Question 10

Describe doxycycline

Answer 10

Decreased side effects vs. tetracycline or minocycline

Question 11

Describe metranidazole

Answer 11

Inhibits DNA synthesis; Bactericidal against anaerobes; discolors urine; i.e. Flagyl

Question 12

Describe clindamycin

Answer 12

Inhibits protein synthesis; bacteriostatic against anaerobes; good in people allergic to pcn; risk of C. difficile infection

Question 13

Describe Azithromycin

Answer 13

Good against anaerobes and gram negative bacilli; concentrates in perio lesions

Question 14

What are some disadvantages of using systemic abx?

Answer 14

Abx can’t achieve high GCF concentrations, risk for adverse reactions, more abx resistance, patient compliance

Question 15

Name two kinds of drugs that modify host responses to the plaque.

Answer 15

NSAIDs and Peirostat

Question 16

Describe periostat

Answer 16

Inhibits anticollagenase activity w/o inhibiting protein synthesis in bacteria