Treatment of Dental Abscess and Other Infections Flashcards
What is usually the cause of a dental abscess?
Polymicrobial (mix of gram positive and gram negative rods)
Why are antibiotics not usually appropriate for dental abscesses?
- Infection is localised to peri-radicular tissues
- Abscess is mostly isolated from circulation
- Resulting in very little antibiotic penetration
What clinical presentations that may arise from a dental abscess would lead you to send a patient to hospital? (3)
- Extra oral swelling
- Eye closing
- Trismus
Give a regime to treat dental abscess using amoxicillin
- Amoxicillin Capsules 500 mg
- 500 mg three times daily for 5 days
- 15 capsules
What does Metronidazole interact with badly?
- Interacts with alcohol
- Disulfiram like reaction
What drugs can be prescribed to treat dental abscess? (6)
- Amoxicillin
- Metronidazole
- Macrolides
- Clindamycin
- Co-Amoxiclav
- Cephalosporins
Name 3 macrolides used to treat dental abscess
- Azithromycin
- Clarithromycin
- Erythromycin
Which of the 3 macrolides used to treat dental abscess has the longest half life?
Azithromycin
What is a downside of Azithromycin? (2)
- Expensive
- Susceptible to resistance
What are some adverse affects from macrolides? (4)
- Prolong QT interval
- Can cause jaundice
- Reduce dose in renal impairment
- Enzyme inhibitors
What can be used for second line treatment for dental abscess? (2)
- Clindamycin
- Co-amoxiclav
When may you use Clindamycin? (2)
- Abscess not responded to amoxicillin/metronidazole
- Severe case in penicillin allergic patients
What is Clindamycin active against?
Gram-positive cocci
Streptococci
What may Clindamycin induce?
What do you have to warn a patient about this?
- Antibiotic colitis
- Warn patients to stop treatment if diarrhoea occurs & contact GP
When may you use Co-Amoxiclav? (2)
- If not respond to other microbial
- Severe infection with spreading cellulitis
