Antibiotics:
Antibiotics are antimicrobial substances that treat or prevent infections caused by bacteria. They work by either killing the bacteria or inhibiting its growth. The era of antimicrobial therapy began with the production of Penicillin in 1928 by Alexander Fleming. Later on, it was mass-produced to be used in clinical settings.
Antibiotic therapy is crucial to controlling infections. We routinely prescribe them in the dental practice. We use them for therapeutic and also for prophylactic use. In the past, before the discovery of antibiotics, even a simple infection or injury could kill. As of now, hundreds of antibiotics are available in the market.
Antibiotic, Medicine, Packaging, Capsule – Medicine, Medical Exam
Types of antibiotics used in dentistry:
Here is a list of commonly prescribed antibiotics in the Dental practice:
1. Penicillin:
Fleming derived penicillin from a specific mold (a type of fungi)—Penicillium. It is a narrow-spectrum antibiotic. Penicillin is highly effective against many bacterial species, which are Streptococcus and Staphylococcus. Allergic reactions are common with penicillin, so we should use it with care. However, in the dental office, it is prescribed as a first-line antibiotic to treat several types of infections.
Use:
Respiratory, ear, skin, STDs, and dental infections including dental abscess, pericoronitis, sinusitis, periodontal disease. It is also used as antibiotic prophylaxis. Antibiotic prophylaxis means prescribing an antibiotic before an invasive procedure in high-risk patients. Therefore, used in patients who are immunocompromised or who have a history of endocarditis.
Side effects:
Rash, diarrhea, nausea, and abdominal pain.
Examples:
- Amoxicillin
- Ampicillin
- Penicillin G
- Penicillin V
2. Cephalosporin:
Cephalosporins are narrow-spectrum antibiotics and are like penicillin in structure. Similarly, the anti-microbial activity of both the groups is same. This group of antibiotics also belongs to the beta-lactam group. Similarly, cephalosporin is derived from a fungus—Cephalosporium. In contrast to penicillin, cephalosporins have five generations. Each generation covers a different class of bacteria. Cephalosporins are related to penicillin, thus people allergic to penicillin may also react to this group.
Use:
Meningitis, respiratory infection, UTI, skin, and dental infections. Just like the penicillin group, we also use it as antibiotic prophylaxis in dental sittings.
Side Effects:
The side effects caused by cephalosporins are mostly GI-related. Includes, diarrhea, nausea, heartburn, and also abdominal pain.
Examples:
- Cefixime
- Cefpodoxime
- Cefuroxime
- Cephalexin
3. Macrolides:
Macrolides are a completely different class of antibiotics from beta-lactams. Thus, they are useful for people who are allergic or resistant to the Beta-Lactam class of antibiotics. However, Macrolide has a lot of drug interactions. Therefore, we should use them with care. Also, make to tell your doctor and pharmacist about all the other medications you are taking.
Use:
Respiratory infections, ear infections, skin diseases, STDS, and periodontal infections.
Side effects:
Nausea, vomiting, abdominal ache, and diarrhea.
Examples:
- Azithromycin (‘Z-pak’)
- Clarithromycin
- Erythromycin
Conclusion:
Antibiotics have an important role in healthcare. Though we should use it with care, knowing the complete patient’s history and allergies to prevent any reaction. We use penicillin as the first line against infections, so are the cephalosporins. Most people who are allergic to penicillin will react to the cephalosporin group as well. It is important to understand why and when should we use each class.
