Mahuli Simpy Amit, Zorair Ali M, Jafer Mohammed Abdurabu, Sultan Alnomari, Sarode Gargi, Baeshen Hosam Ali, Raj A Thirumal, Sarode Sachin, Patil Shankargouda
Public Health Dentist, Ranchi, Jharkhand, India.
Pharmacy Comprehensive Specialized Clinics of Security Forces of Jazan, Jazan, Kingdom of Saudi Arabia.
J Contemp Dent Pract. 2020 Apr 1;21(4):372-376.
The review is to highlight the use of antibiotics in periodontal infections and prevent indiscriminate use of antibiotics.
Periodontitis is the most common disease of the periodontal attachment apparatus, and its etiological factor can be related to the existence of virulent microorganisms in the dental plaque biofilm which harbors millions of microorganisms. In addition, the pathogenesis of this disease is greatly influenced by the host immune response that leads to the cyclic destruction and healing pattern.
Periodontitis is mostly treated through mechanical debridement using surgical and nonsurgical therapy. However, many times, this treatment does not render desired results due to poor patient compliance, altered immune response, or other host-related factors. This leads to the administration of antibiotics as an adjunct to mechanical debridement. Antibiotics are useful in eliminating periodontopathic microbes, but these agents should be cautiously used and prescribed only if indicated.
Indiscriminate use of antibiotics can lead to unforeseen adverse effects as well as the development of resistant strains of microorganisms.
Hence, it is crucial for the dentists to know the indications, contraindications, undesirable effects, correct choice, and dosage of the antimicrobial agent before prescribing it to their patients thereby ensuring the success of periodontal therapy. Thus, the clinician should keep in mind that the antibiotics are merely adjuncts to mechanical therapy and not its replacement.
本综述旨在强调抗生素在牙周感染中的应用,并防止抗生素的滥用。
牙周炎是牙周附着装置最常见的疾病,其病因可能与牙菌斑生物膜中存在的致病性微生物有关,牙菌斑生物膜中含有数百万种微生物。此外,这种疾病的发病机制受宿主免疫反应的极大影响,导致周期性破坏和愈合模式。
牙周炎大多通过手术和非手术治疗进行机械清创来治疗。然而,由于患者依从性差、免疫反应改变或其他宿主相关因素,这种治疗很多时候无法取得理想效果。这就导致将抗生素作为机械清创的辅助手段使用。抗生素有助于消除牙周病原菌,但这些药物应谨慎使用,仅在有指征时才开具处方。
滥用抗生素会导致不可预见的不良反应以及微生物耐药菌株的产生。
因此,对于牙医来说,在给患者开抗菌药物之前了解其适应证、禁忌证、不良影响、正确选择和剂量至关重要,从而确保牙周治疗的成功。因此,临床医生应牢记,抗生素仅仅是机械治疗的辅助手段,而不是替代手段。