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MAXILLOFACIAL SURGERY
ANTIBIOTIC TERMINOLOGY
Glycopeptides
○ Vancomycin, Teicoplamin
Oxazolidinase
○ Linezolid
Nitrofuran derivatives
○ Nitrofurantoin, Furazolidine
Nitroimidazoles
○ Metronidazole, Tinidazole
Polyene antibiotics
○ Nystatin, Amphotericin - B, Hamycin
Azole derivatives
○ Miconazole, clotrimazole, ketoconazole, fluconazole
SPECTRUM OF ACTIVITY
Narrow spectrum
Penicillin G, streptomycin and
erythromycin.
Broad spectrum
Tetracyclines, chloramphenicol.
Extended spectrum
Semi synthetic Penicillins, new
cephalosporins, aminoglycoside.
CLASSIFICATION
(v) TYPE OF ACTION:
Primarily Bacteriostatic Primarily
Bactericidal
Sulfonamides Penicillins , Cephalosporins,
Tetracyclines Aminoglycosides,
Chloramphenicol Vancomycin,
Erythromycin Ciprofloxacin, Isoniazid ,
Ethambutol Rifampin, Cotrimoxazole,
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SOURCE
Fungi
Penicillin, Cephalosporin, Griseofulvin.
Bacteria
Polymyxin B, Colistin, Bacitracin, Tyrothricin
Aztreonam.
Actinomycetes
Aminoglycosides, Tetracyclines, Chloramphenicol,
Macrolides, Polyenes.
PRINCIPLES OF ANTIBIOTIC THERAPY
PRINCIPLE 1: DETERMINE THE SEVERITY OF
INFECTION
Physical examination
2)EVALUATE STATE OF
PATIENT’S HOST DEFENSE
MECHANISMS
Uncontrolled metabolic diseases
e.g. - uremia, alcoholism, malnutrition, severe diabetes
(decreased function of leucocytes, decreased
chemotaxis, decreased phagocytosis, decreased
bacterial killing)
Drainage of pus
Reduction in tissue tension
Improved local blood supply and increased
delivery of host defenses
5)SUPPORT THE PATIENT
MEDICALLY
Odontogenic infection
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PRINCIPLES FOR CHOOSING APPROPRIATE
ANTIBIOTIC
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PRINCIPLES FOR CHOOSING
APPROPRIATE ANTIBIOTIC
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PRINCIPLES FOR CHOOSING
APPROPRIATE ANTIBIOTIC
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PRINCIPLES FOR CHOOSING APPROPRIATE
ANTIBIOTIC
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PRINCIPLES FOR CHOOSING APPROPRIATE
ANTIBIOTIC
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PRINCIPLES FOR CHOOSING APPROPRIATE
ANTIBIOTIC
Advantages -
less chances of developing resistant organisms.
E.g. streptococcus sensitive to penicillin , cephalosporin and
tetracycline.
Minimizes the risk of super infections.
E.g. moniliasis and gram negative pneumonias
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PRINCIPLES FOR CHOOSING APPROPRIATE
ANTIBIOTIC
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PRINCIPLES FOR CHOOSING APPROPRIATE
ANTIBIOTIC
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PRINCIPLES FOR CHOOSING APPROPRIATE
ANTIBIOTIC
3. Faster results
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PRINCIPLES FOR CHOOSING APPROPRIATE
ANTIBIOTIC
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PRINCIPLES FOR CHOOSING APPROPRIATE
ANTIBIOTIC
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PRINCIPLES FOR CHOOSING APPROPRIATE
ANTIBIOTIC
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Indications for use of
antibiotics
Rapidly progressive swelling
Diffuse swelling
Compromised host defenses
Involvement of facial spaces
Severe pericoronitis
Osteomyelitis
Use of antibiotics is not
necessary
Chronic well localized abscess
Dry socket
Mild pericoronitis
INDICATIONS OF EMPIRICAL
ANTIBIOTIC THERAPY :
The site and feature of the infection have been
well defined.
Proper dose.
Proper time interval.
Proper route of administration.
Combination antibiotic therapy.
PRINCIPLES OF ANTIBIOTIC THERAPEUTIC DOSE
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DRUG DOSE CALCULATION
BASED ON BODY SURFACE AREA
YOUNG’S FORMULA :
INDICATIONS :
1.The half-life of the antibiotic is longer
than 3-hours.
2. A delay of longer than 12-hours to
achieve therapeutic blood levels is unacceptable.
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PRINCIPLES OF ANTIBIOTIC THERAPEUTIC DOSE
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PRINCIPLES OF ANTIBIOTIC THERAPEUTIC DOSE
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PRINCIPLES OF ANTIBIOTIC THERAPEUTIC DOSE
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PRINCIPLES OF ANTIBIOTIC THERAPEUTIC DOSE
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MINIMAL INHIBITORY CONCENTRATION
Is the lowest antibiotic concentration that prevents growth
of microorganism after an incubation period of 18 - 24
hours incubation period with a standard inoculum of 104
to 105 cfu/ml