An#bio#cs  List  2012

Antibiotic(Class)

Infection Example/Typical Dose

(5-7 days)

Mech of Action MetabolismExcretion

Side Effects Pregnancy/Breast Feeding

Penicillin/Amoxicillin(Penicillins)

Odontogenic InfectionAmox: IE Prophylaxis

Up to 2000mg load250-500 mg t.i.d.(Take on empty stomach)IE: 2g 1 hr before appt

Bactericidal:Cell Wall Synthesis inhibitor - binds to PBP inhibit peptidoglycan synthesis

Met: HepaticExcr: Kidney

Hypersensitivity (rash): 5%Diarrhea: 5%

Preg Cat: BBF: Enters breast milk - caution recommended

Tetracycline(Tetracycline)

Periodontics 200 mg q.d.Antacids may dec absorption

Bactericidal: Inhibits bacterial protein synthesis by binding with the 30s and/or 50s ribosomal subunits of susceptible bacteria

Met: CYP3A4Excr: Kidney/Fecal

Photosensitivity Preg Cat: DBF: AAP considers tetracycline to “compatible”

Clindamycin(Lincosamide)

Odontogenic InfectionIE Prophylaxis

300 mg t.i.d. or q.i.d.IE: 600mg 1hr before appt

Bacteriostatic or cidal:Binds to the 50s ribosomal subunit of susceptible bacteriaStatic and/or cidal conc, infections site, and organism

Met: HepaticExcr: Biliary/renal

Diarrhea: 7%Pseudomembranous Colitis

Preg Cat: BBF: AAP suggests that it is “fairly” safe.

Metronidazole(Nitroimidazole)

Anaerobic Odontogenic Infection

500 mg b.i.d. or t.i.d. Bacteriostatic:Binds to bac DNA

Met: HepaticExcr: Biliary/renal

Nausea/vomiting: 12%(Antabuse)

B (Avoid 1st trimester)BF: AAP rates “concern”

AugmentinClavulanic AcidAmoxicillin

Tx of orofacial infections when b-lactamase prod bac present

875 b.i.dDose is based on amoxicillin

Bactericidal:Cell Wall Synthesis inhibitor - binds to PBP inhib peptidoglcn syn Clavulanate binds/inhibs beta-lactamases

Met: HepaticExcr: Kidney

Diarrhea: 3-34% Preg Cat: B BF: Enters milk, use w/ caution

Azithromycin(Macrolide)

Odontogenic Infection alternative

250-500 mg q.d. Bacteriostatic:Binds to 50 ribosomal subunit

Met: HepaticExcr: Kidney

Diarrhea (4-9%)Nausea (<7%)

Preg Cat: B BF: Enters milk, use w/ caution

Cephalexin(Cephalosporin)

Prophylaxis in total joint replacement patients

250-1000mg every 6hrsMax: 4 g/day

Bactericidal:Cell Wall Synthesis inhibitor - binds to PBP inhibit peptidoglcn syn

Met: HepaticExcr: Kidney

Diarrhea (4-9%)Nausea (<7%)

Rpeg Cat: B BF: Enters milk, use w/ caution

Ciprofloxacin(Fluorquinolone)

Periodontics 500 mg b.i.d. Bactericidal:Inhibs DNA gyrase

Met: HepaticExcr: Kidney

Diarrhea (4-9%)Nausea (<7%)

Preg Cat: B BF: Enters milk, not recommended