BIBLE Questions

Question 1

When is antibiotic prophylaxis required?

Answer 1

1. prosthetic cardiac valve
2. prosthetic cardiac valve repair
3. history of IE
4. cardiac transplant that develops a problem in a heart valve
5. specific serious congenital heart conditions
   - unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits.
   -a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure
   - any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device

NOT required for:
1. mitral valve prolapse
2. rheumatic heart disease
3. bicuspid valve disease
4. calcified aortic stenosis
5. congenital heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy

Question 2

Name local animicrobials and dosages

Answer 2

1 . Arestin- minocycline microsphere 1mg, releases over 21 days
2. Atridox- doxycycline 10%, gel that hardens
3. Periochip- 2.5mg chlx chip inserted into pockets

Question 3

Limitations of local antimicrobials

Answer 3

1. cannot maintain concentration over time
   2.small size of drug resevoir
   3.limited clinical benefits
2. limited short term effectiveness @ furcation sites

Question 4

Antibiotic prescriptions in periodontitis

Answer 4

Chronic periodontitis: if AA present =Amox+metronidazole 250mg each TID for 8 days

Acute periodontitis: AA often present, bacterial load often minimal, possible PMN effect

Refractory periodontitis: does not respond to conventional treatment = Cipro/ low (subtherapeutic) dose doxy, decreases collagenase activity or serial doxy (static) and metronidazole (cidal)- 40% improvement (i.e decrease in AL)

Abscess: Amox 500mg QID for 7 days + metro 500 mg TID for 7 days + Clindamycin 300mg TID for 7 days.

Question 5

Prescription for Pen V

Answer 5

300mg QID for 7 days

Question 6

Prescription for Amoxicillin

Answer 6

500mg TID for 7days

Question 7

Prescription for Calvulin

Answer 7

250/500mg TID for 7days

Question 8

Prescription for Metronidazole

Answer 8

250mg TID for 7 days OR 500mg BID or 7 days

Question 9

Prescription for Tetracycline

Answer 9

250mg QID for 21 days

Question 10

Prescription for Clindamycin

Answer 10

150-300mg QID for 7 days

Question 11

Prescription for Ciprofloxacin

Answer 11

500mg BID for 7 days

Question 12

What is the rationale for giving amoxicillin and metronidazole together?

Answer 12

1. synergy (decrease dose of each)
2. broader range
3. prevent super infection

Question 13

What is PERIOSTAT

Answer 13

20mg