口腔颌面外科抗生素的应用（英文ppt）antibioticsin oral and maxillofacial

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1、AntibioticsInOralandMaxillofacialSurgeryZiadMalkawiDDS,MSc,Max.Fac.s.Cert.,FFDRCSIOralandMaxillofacialSurgeryFacultyofDentistryUniversityofJordanDefinitionsAntimicrobialagents:AnyInhibitorofmicrobialgrowth.Antibiotcagents:Strictly–naturallyproducedinhibitorofmicrobialgrowth.Semi–synthetic

2、antibiotic:Agentderivedbymodificationofanaturalantibiotic.TheIdealAntibioticShouldhavemaximaltoxicityforthepathogenwhilstcausingtheminimumdamagetothehosttissue.Thisiswhat’scalled:(SelectiveToxicity)AntibioticsConsider:Route.Absorption.Excretion.Bacterio-staticorbacterio-cidal.Wayofaction.

3、Cost.AntibioticandHumanhostConsider:Allergy.Ageandweightofthepatient.Medicalproblems:Liverfailure.Renalfailure.Immuno-suppressedpatient.Gastrointestinaltractdiseases.Pregnancy:Amoxycillin,Cephalosporin,Gentamicin.AntibioticandMicro-organism/InfectionConsider:Severityofinfection.Typeoforga

4、nism:G+veorG–vebacteria.Aerobicoranaerobicormixedbacteria.Resistance.Siteofinfection:Brain,softtissue,bone,Sinuses,kidneyetc.Stateofpatient:Septic,pyretic,dehydratedetc.SelectivetoxicityisbestachievedwhereanantimicrobialagentblocksametabolicpathwaySuitabletargetsIncludes:Bacterialcellwall

5、synthesis.Bacterialproteinsynthesis.Folicacidsynthesis.Nucleicacidmetabolism.Membranedisorganizingagents.1)AntibioticwhichinhibitcellwallsynthesisBeta–lactams:Penicillins:mainlyagainstG+vebacteriaCephalosporin:1stgeneration–Cephroxine.2ndgeneration–cephrorixime.3rdgeneration–cephrotaxine:

6、cancrossBBBMono-lactams.Carbapenems.Augmentin:Amoxycillin+GlavulanicacidAmoxycillin:Againstaerobicandanaerobicbacteria.Antibioticwhichinhibitcellwallsynthesis2.Antibioticswhichinhibitpeptidoglycansynthesis:Cycloserine.Phosphonomycin(Fosfonomycin).Bacitracin.Vancomycin.Teichoplanin.2)Antib

7、ioticwhichinhibitproteinsynthesisAminoglycoside:(AllarebacteriocidalexceptSpectinomycin)Gentamicin:againstG–veCan’tcrossBBB.Can’tcrosspuss.Goodforseptecaemiaandbacteraemia.Tetracyclin:Doxycyclin,Oxytetracyclin.Chloramphenicol.Erythromycin–Clarythromycin.Lincomycinan