ANTIBIOTICS IN DENTAL MEDICINE

Antibiotici su antibakterijski lijekovi koji pripadaju skupini antimikrobnih kemoterapeutika. Oni su česta terapijska sredstva u kliničkoj praksi doktora dentalne medicine. Zbog prisutnosti patogena rezistentnih na njihovo djelovanje, važno je poznavati svojstva, mehanizme djelovanja, indikacije i popratne neželjene učinke koje nosi primjena antibiotika, a koji su detaljno opisani u ovom diplomskom radu. U dentalnoj medicini koriste se antibiotici iz skupine penicilina, tetraciklina, makrolida, linkozamida, fluorokinolona te metronidazol koji pripada i u skupinu amebicida. Prepisuju se kao terapijska i profilaktička sredstva, uneseni u organizam peororalno, intravenski, intramuskularno ili primijenjeni topikalno na sluznicu usne šupljine. Amoksicilin pripada skupini penicilina, djeluje razarajući staničnu stjenku bakterija. Širokog je spektra, zbog prisutnosti bakterijske rezistencije često se primjenjuje u kombinaciji s klavulanskom kiselinom. Lijek je izbora za dentalne infekcije i prepisuje se empirijski ako bolesnik nije preosjetljiv na peniciline. Doksiciklin je tetraciklin, djeluje sprječavajući sintezu bjelančevina bakterije, vežući se na bakterijske ribosomske podjedinice. Širokog je spektra i najčešće se koristi kod prisutnosti bakterijske rezistencije u bolesnika s parodontnim bolestima. Eritromicin i azitomicin su makrolidi širokog spektra, djeluju sprječavanjem sinteze bakterijskih bjelančevina vežući se na veliku ribosomsku podjedinicu bakterija. Klindamicin pripada skupini linkozamida, širokog je spektra i istog mehanizma djelovanja kao opisani makrolidi. Prepisuje se empirijski u slučaju postojanja preosjetljivosti bolesnika na peniciline te je uspješan u liječenju infekcija kosti. Ciprofloksacin je fluorokinolon koji djeluje na bakterije sprječavajući replikaciju njihove deoksiribonukleaze, a najdjelotvorniji je lijek kod parodontnih bolesti uzrokovanim bakterijom Agregatibacter actinomicetemcomitans. Metronidazol djeluje na anaerobne bakterije sprječavanjem sinteze nukleotida. Metronidazol i penicilini su baktericidi, a makrolidi i tetraciklini bakteriostatici.Antibiotics are antibacterial medicines belonging to the group of antimicrobial chemotherapy drugs. Dentists use them often as common therapeutical agents. Due to the presence of pathogens resistant to their activity, it is important to know the properties, mechanisms of action, indications, and side effects of antibiotic use, which are described in detail in this master thesis. Dental medicine uses antibiotics from the group of penicillin antibiotics, tetracyclines, macrolides, linkozamides, fluoroquinolones, and metronidazole, which belongs to the amebicide group. They are prescribed as therapeutical and prophylactic agents, ingested orally, intravenuously, intramuscularly, or applied topically on the mucous membrane of the oral cavity. Amoxicilin belongs to the group of penicillin antibiotics and it has a devastating effect on the bacterial cell wall. It has a wide range of applications and due to the presence of bacterial resistance, it is often administered in combination with clavulanic acid. Amoxicilin is a medicine of choice for dental infections and is prescribed empirically if a patient is not penicillin-sensitive. Doxycycline is tetracycline and it acts to inhibit the synthesis of bacterial proteins by binding to the bacterial ribosomal subunits. It has a wide range of applications and is most often used in the presence of bacterial resistance in patients with periodontal diseases. Erythromycin and azithromycin are macrolides with broad spectrum of use preventing the synthesis of bacterial proteins by linking to a large ribosomal subunit of bacteria. Klindamycin belongs to the group of linkosamides, it has a wide spectrum of use and the same mechanism of action as the macrolides described above. It is prescribed empirically in the case of penicillin-sensitive patients and is successful in treating bone infections. Ciprofloxacin is a fluoroquinolone that acts on bacteria by preventing the replication of their deoxyribonuclease and is the most effective medicine in periodontal diseases caused by the Agregatibacter acetinomicetemcomitans bacteria. Metronidazole acts on anaerobic bacteria by inhibiting nucleotide synthesis. Metronidazole and penicillin antibiotics are bactericidal while macrolides and tetracyclines are bacteriostats