Mitchell D A
J Clin Periodontol. 1984 Mar;11(3):145-58. doi: 10.1111/j.1600-051x.1984.tb01318.x.
The increasing awareness of the role of obligate anaerobic bacteria in the aetiology of oral disease has led to an interest in their chemotherapeutic control. Many drugs are capable of eliminating anaerobes but in instances where these bacteria are acting as sole or major pathogens it is desirable to remove these specifically. The nitroimidazole group of drugs is specifically anti-anaerobic in nature and includes metronidazole, nimorazole and tinidazole. This paper reviews the literature on metronidazole. This drug is absorbed well from the gastrointestinal tract and can be detected at bactericidal levels in blood and saliva within 1 h of ingestion. The mode of action of metronidazole is unknown but thought to concern intracellular reduction of the molecule. The drug acts specifically against anaerobes and does not disturb the commensal aerobic flora; resistance very rarely develops. The dosage recommended for use in dentistry would appear to be very safe. Metronidazole has important interactions with alcohol, disulfiram and warfarin and there are contraindications to its use. Metronidazole has been proved to be efficacious in treating: acute ulcerative gingivitis, pericoronitis, certain periapical infections, some cases of osteomyelitis and infected socket. The drug may be of use in cases of chronic progressive periodontitis where anaerobes are implicated as pathogens.
对专性厌氧菌在口腔疾病病因学中作用的认识不断提高，引发了人们对其化学治疗控制的兴趣。许多药物能够消除厌氧菌，但在这些细菌作为唯一或主要病原体起作用的情况下，特别希望能专门清除它们。硝基咪唑类药物本质上具有特异性抗厌氧菌作用，包括甲硝唑、尼莫唑和替硝唑。本文综述了关于甲硝唑的文献。该药物从胃肠道吸收良好，摄入后1小时内可在血液和唾液中检测到杀菌水平。甲硝唑的作用方式尚不清楚，但认为与分子的细胞内还原有关。该药物特异性作用于厌氧菌，不会干扰共生需氧菌群；耐药性极少出现。牙科推荐使用的剂量似乎非常安全。甲硝唑与酒精、双硫仑和华法林有重要相互作用，使用时有禁忌证。甲硝唑已被证明在治疗以下疾病方面有效：急性溃疡性牙龈炎、冠周炎、某些根尖周感染、一些骨髓炎病例和感染性牙槽窝。该药物可能对厌氧菌作为病原体的慢性进行性牙周炎病例有用。
