In the Health Light blog, we will learn about Definition, Classification,
factors are important in the choice and adverse effects of Antibiotic . All you have to do, dear reader,
is to follow to the end
Definition of antibiotic
An antibiotic denotes a substance that is of biological origin ; whereas , a chemotherapeutic agent denotes a chemical made synthetically. The term “ antimicrobial ” agent is an inclusive term referring to either an antibiotic or chemothera - peutic agent .factors are important in the choice of a suitable antibiotic
Before selecting an antibiotic for the treatment of an infection the dentist must first consider two major factors: the patient and the susceptibility of the bacteria . Factors related to the patient that must be considered when selecting the appropriate antibiotic include :• history of allergy to antibiotics
• renal and hepatic function
• resistance to infection (e.g., whether a compromised host )
• ability to tolerate oral drugs
• severity of the infection
• age
• if female , whether pregnant, nursing or taking an oral contraceptive.
Duration of antibiotic administration
Duration of therapy depends on the nature of the infection and the response to treatment . Courses should not be unjustifiably prolonged because it is wasteful and may lead to adverse effects including antibiotic resistance . If the patient has not clinically improved by the 3rd day, then the antibiotic should be stopped and another antibiotic started .Classification of Antibiotic
According to the mechanism of actionbactericidal and bacteriostatic antibiotics
First, antibiotics must enter the bacteria in order for it to be effective. Bactericidal antibiotics work by killing the bacteria as a result of inhibiting bacterial cell wall synthesis or interfering with bacterial DNA . Bacterial cells must be multiplying for a bactericidal antibiotic to be effective. A bacteriostatic antibiotic weakens, disables, and reversibly
inhibits the growth and replication of bacteria thereby giving the body ’ s natural defense mechanisms time to become effective in overcoming an infection. If an infection is quiet without multiplying and forming new protein, the bacterio-static antibiotic will not work .
Bacteriostatic antibiotic can become bactericidal either increasing the dose of the bacteriostatic antibiotic or combine it with another bacteriostatic antibiotic .
Bacteriostatic :
tetracyclinet - macrolides (erythromycin) , azilides ( azithromycin , clarithromycin ) clindamycin
Bactericidal :
penicillins , cephalosporins , quinolones , metronidazole
According to the spectrum of influence :
narrow-spectrum and a broad-spectrum antibiotic :
Narrow-spectrum antibiotics are effective against only a limited range or organisms, such as Gram-negative or Gram-positive bacteria.
Broad-spectrum antibiotics affect a wider range against Gram-negative and Gram-positive bacteria. It is recommended to choose a narrow spectrum antibiotic when treating non-life threatening dental infections . The primary indication for use of broad-spectrum antibiotics coverage is in severe life-threatening dental infections where identification
of causative agent is unknown. Every time bacteria are exposed to antibiotics, the opportunity for development of resistant strains is present. If narrow-spectrum antibiotics are used fewer bacteria have the opportunity to become resistant. Also, specific narrow-spectrum antibiotics usually are more effective against specific susceptible bacteria than the broad-spectrum antibiotics.
Narrow-spectrum antibiotics : penicillin VK, erythromycin, azithromycin, clarithromycin, clindamycin.
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Extended-spectrum antibiotics: amoxicillin, amoxicillin/clavulanate (Augmentin).
Broad-spectrum antibiotics: tetracyclines (doxycycline, minocycline), ciprofloxacin (Cipro).
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adverse effects of antibiotics and managed it
Antibiotics , especially broad-spectrum , alter the microflora of the stomach resulting in diarrhea and fungal infec-tions . To help avoid this problem it is beneficial to consume living organisms referred to as probiotics
• Superinfections : fungal infections (e.g., vaginal) and infections by other bacteria include enteric rods ,
pseudo-monads , and staphylococci are especially more prone with broad-spectrum antibiotics but can occur with any. The narrow-spectrum antibiotic will not kill as many of the normal microorganisms in the body as the broad spectrum antibiotics. So , it has less ability to cause superinfection . This occurs because the bacteria are targeted which allow for growth of Candida sp. To help avoid this it is recommended to all patients, especially females, to either
eat yogurt ( containing live and active cultures such as Kefir, Dannon or Yoplait ) .To prevent antibiotic-related
suprainfections about 5 ounces of yogurt should be taken twice daily while on the antibiotic . An alternative
method is to take acidophilus supplementation (capsule), which is available in the alternative therapy section of
the store . As long as the product is produced by a reliable manufacturer, most acidophilus supplements are
relatively equal , and should not cause unpleasant side effects; some cause slight bloating for the first few days or
weeks of taking the product , but this does not usually last . Lactobacillus acidophilus is one of the bacteria found in these supplements , but the term acidophilus usually refers to a combination of L. acidophilus with other beneficial bacteria .
• Gastrointestinal problems ( nausea , vomiting, and diarrhea ) : To help avoid antibiotic-related diarrhea it is recom-mended to all patients to eat yogurt ( containing live and active cultures such as Kefir , Dannon or Yoplait ) . Approximately 4 to 8 ounces of yogurt should be taken twice daily while on the antibiotic. Yogurt should be taken at least 2 hours before or 2 hours after the antibiotic . However , antibiotic-associated diarrhea that is constant and watery / bloody diar-rhea ( new onset of >3 partially formed or watery stools per 24 hour period ) can be caused by toxins released from Clostridium difficile resulting in pseudomembranous colitis or C.difficile - associated diarrhea C.difficile is the leading known cause of nosocomial intestinal infections If this happens the patient should discontinue the antibiotic and call emergency services . The patient should not take antidiarrheal medications because it is advantageous to eliminate the bacterial toxins . Pseudomembranous colitis symptoms could appear after a few doses or from 2 to 9 days or even months after the start of antibiotic therapy; it could happen at any time while taking the antibiotic . Unless it is known that the patient has a proclivity toward pseudomembranous colitis, it is not known if the patient will develop it . In reality , any antibiotic can cause pseudomembranous colitis . Any antibiotic can cause pseudomembranous colitis , but if used appropriately there are fewer incidences .
• Antibiotic resistance : The narrow-spectrum antibiotic will cause less resistance of the bacteria as it will deal with only specific bacteria . This is the reason for initially choosing a narrow-spectrum antibiotic. Antibiotic resistance is an increasing problem worldwide .
• Allergic reactions : Allergic reaction ranging from a mild rash to wheezing and anaphylaxis. The antibiotic should be discontinued immediately.
• Photosensitivity : exaggerated sunburn when taking doxycycline. Avoid sunlight.
oral bacteria are obligate or strict
anaerobes :
Gram-positive obligate anaerobic coccus: Peptostreptococcus spp.
Gram-positive obligate anaerobic rods: Eubacterium spp.
Gram-negative obligate anaerobic rods: Porphyromonus gingivalis , Prevotella intermedia , Tannerlla forsynthensis (for-merly Bacteroides forsythus ), Fusobacterium nucleatum .
Gram-negative anaerobic spirochete : Treponema spp.
aerobes :
Obligate aerobic: Mycobacterium tuberculosis , Pseudomonas aeruginosa
Thus, we have finished reviewing the most important points about Definition, Classification,
factors are important in the choice and adverse effects of Antibiotic . Don't forget to share the topic on social media
resources and references
The Dentist’s Drug and Prescription GuideMea Weinberg and Stuart J. Froum
Stuart L. Segelnick, Consulting Editor
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