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牙科实践中的抗生素使用。一篇综述。

Antibiotic use in dental practice. A review.

作者信息

Poveda Roda Rafael, Bagan José Vicente, Sanchis Bielsa José María, Carbonell Pastor Enrique

机构信息

Service of Stomatology, Valencia University General Hospital, Valencia, Spain.

出版信息

Med Oral Patol Oral Cir Bucal. 2007 May 1;12(3):E186-92.

Abstract

Antibiotics are commonly used in dental practice. It has been estimated that 10% of all antibiotic prescriptions are related with dental infections. The association amoxicillin-clavulanate was the drug most frequently prescribed by dentists during 2005, at least in the Valencian Community (Spain). The use of antibiotics in dental practice is characterized by empirical prescription based on clinical and bacteriological epidemiological factors, with the use of broad spectrum antibiotics for short periods of time, and the application of a very narrow range of antibiotics. The simultaneous prescription of nonsteroidal antiinflammatory drugs (NSAIDs) can modify the bioavailability of the antibiotic. In turn, an increased number of bacterial strains resistant to conventional antibiotics are found in the oral cavity. Antibiotics are indicated for the treatment of odontogenic infections, oral non-odontogenic infections, as prophylaxis against focal infection, and as prophylaxis against local infection and spread to neighboring tissues and organs. Pregnancy, kidney failure and liver failure are situations requiring special caution on the part of the clinician when indicating antibiotic treatment. The present study attempts to contribute to rational antibiotic use, with a review of the general characteristics of these drugs.

摘要

抗生素在牙科实践中普遍使用。据估计,所有抗生素处方中有10%与牙科感染有关。阿莫西林-克拉维酸盐组合是2005年牙医最常开具的药物,至少在西班牙巴伦西亚自治区是这样。牙科实践中抗生素的使用特点是基于临床和细菌学流行病学因素的经验性处方,短期使用广谱抗生素,且使用的抗生素种类非常有限。同时开具非甾体抗炎药(NSAIDs)会改变抗生素的生物利用度。反过来,口腔中发现对传统抗生素耐药的细菌菌株数量增加。抗生素适用于治疗牙源性感染、口腔非牙源性感染、作为预防局灶性感染以及预防局部感染并扩散至邻近组织和器官。怀孕、肾衰竭和肝衰竭是临床医生在开具抗生素治疗时需要特别谨慎的情况。本研究试图通过回顾这些药物的一般特性,为合理使用抗生素做出贡献。

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