aneoi7 Dental Abscess Mecialion:Aniticties This site is intended for healthcare professionals Medscape Dental Abscess Medication Updated: Aug 02, 2016 Author: Jane M Gould, MD, FAAP; Chief Editor: Russell W Steele, MD more. MEDICATION Medication Summary When drainage cannot be achieved or the patient shows signs of systemic involvement, antibiotic therapy is indicated; in addition, an increasing number of immunocompromised patients require antibiotic therapy. Antibiotics Class Summary Empiric antimicrobial therapy must be broad spectrum to cover anaerobes, Staphylococcus aureus, non-typeable Haemophilus influenzae, and others, depending on the context of the clinical setting. The most commonly prescribed antibiotic is amoxicillin/clavulanate. Penicillin (Pfizerpen, Pen-Vee K) * View full drug information Traditionally been considered the DOC for the treatment of a dental abscess. Antibiotic therapy alone, without surgical drainage, may not be effective because of poor antibiotic penetration into the abscess cavity, ineffectiveness at low pH levels, and the inoculum effect. Bactericidal against sensitive organisms when adequate concentrations are reached and is most effective during the stage of active multiplication. Inadequate concentrations may produce only bacteriostatic effects. Binds to one or more penicillin binding proteins, which interferes with bacterial cell wall synthesis during active multiplication, Final transpeptidation step of peptidoglycan synthesis is inhibited leading to death Emergence of beta-lactamase producing bacteria may decreased efficacy, although it remains the antibiotic of choice for mild-to-moderate infections. Azithromycin (Zithromax) + View full drug information May be an option for the treatment of a dental abscess in patients who are allergic to penicillin or beta-lactam. Binds to the 50S ribosomal subunit of susceptible microorganisms and blocks hep lemescine medscape.con/articl90373-meseaortshowal 2uieao17 Dental Abscess Meccan: niiobes dissociation of peptidyl tRNA from ribosomes, inhibiting bacterial RNA-dependent protein synthesis. Concentrates in phagocytes and fibroblasts, as demonstrated by in vitro incubation techniques. In vivo studies suggest that concentration in phagocytes may contribute to drug distribution to inflamed tissues. Indicated for mild-to-moderate microbial infections. Metronidazole (Flagyl) + View full drug information Effective against obligate anaerobic organisms. It can be combined with penicillin if anaerobic ‘organisms that produce beta-lactamase enzymes are a concern. Compliance must be considered with a 2-drug regimen. It inhibits DNA synthesis by affecting the helical DNA structure leading to DNA strand breakage causing cell death. Clindamycin (Cleocin) + View full drug information Can be used in patients who are penicillin or beta-lactam alllergic. Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit preventing peptide bond formation. Excellent activity against PO aerobes and anaerobes; penetrates bone and abscess cavities. Amoxicillin and clavulanate (Augmentin) * View full drug information Amoxicillin works by binding to one or more of the pericillin-binding proteins, which interferes with bacterial cell wall synthesis during active bacterial replication. The final transpeptidation step of peptidoglycan synthesis is inhibited leading to cell death. Clavulanic acid binds and inhibits beta- lactamase enzymes that inactivate amoxicillin resulting in an expanded spectrum of activity for ‘Augmentin, For children, the dosing should be based on the amoxicillin component. Cefoxitin (Mefoxin) + View full drug information Binds to one or more of the penicillin binding proteins, which interferes with bacterial cell wall synthesis during active replication. The final transpeptidation step of peptidoglycan synthesis is inhibited leading to cell death. It is a second-generation cephalosporin with activity against some gram-positive cocci, gram-negative rods, and anaerobic bacteria. Infections caused by cephalosporin-resistant or penicillin-resistant gram-negative bacteria may respond to cefoxitin. Follow-up Iitpvlemecicina medscape.convartcl!90837-medicaiontshowall 22