Systemic Antimicrobials & Periodontal Disease

Question 1

whats the definition of an antimicrobial?

Answer 1

drug that kills, prevents or inhibits growth of microorganisms

Question 2

what’re the 3 types of plaque hypothesis that describe the polymicrobial nature of perio

Answer 2

non-specific
specific
ecological

Question 3

what’re the most common classifications of antibiotics (according to chemical structure)

Answer 3

B-lactams (penicillins)
Sulphonamides
tetracyclines
mactolides

Question 4

what is a narrow spectrum antimicrobial

Answer 4

effects a specific group of microbes

Question 5

what is a broad spectrum antimicrobial

Answer 5

effects a large group of microbes

Question 6

what does bacteriostatic mean

Answer 6

prevent growth of bac

Question 7

what does bactericidal mean

Answer 7

kills bac

Question 8

what’re the 5 modes of action of systemic antimicrobials

Answer 8

1. inhibition of cell wall synthesis
2. inhibition of cytoplasmic membrane function
3. inhibition of nucleic acid synthesis
4. inhibition of ribosomal function & therefore protein synthesis
5. inhibition of folate metabolism

Question 9

what’re some disadvantages (adverse effects) of antibiotics (5)

Answer 9

1. hypersensitivity (anaphylaxis)
2. GI disturbances
3. alterations is commensalism flora (naturally occurring microbiome)
4. drug indications (eg. alcohol, anticoagulants, pregnancy)
5. bacterial resistance

Question 10

what’re some reasons that antimicrobial therapy might fail?
1. lack of____
2. that c_____ a_____ is non-_____
3. incorrect ___
4. p.c.
5. defective___
6. persistant ___
7. d.r.

Answer 10

1. lack of culture & sensitivity
2. non-bacterial causative agent
3. incorrect drug dosage/duration
4. lack of patient compliance
5. defective host responses
6. persistent risk factors (smoking/alcohol)
7. drug resistance

Question 11

Which of the following is NOT a mechanism of action of antibacterial drugs?
1. Breaking of bacterial DNA strands
2. Inhibition of cell wall synthesis
3. Inhibition of capsular material formation
4. Inhibition of protein synthesis

Answer 11

3. inhibition of capsular material formation

Question 12

are antibiotics appropriate for necrotising periodontal diseases

Answer 12

yes

Question 13

are antibiotics appropriate for gingival diseases

Answer 13

no

Question 14

are antibiotics appropriate for chronic periodontitis

Answer 14

no

Question 15

when an antibiotic is needed, which is usually recommended to patients as a first line antibiotic
+ why

Answer 15

phenoxymethylpenicillin
+ less likely to drive antimicrobial resistance

Question 16

what has to be used in unison with antibiotics to remove biofilm

Answer 16

mechanical therapy

Question 17

what’s the management for necrotising periodontal disease + what drug is used (m)

Answer 17

1. removal of supra/sub gingival deposits
2. systemic antibiotics (metronidazole tablets 200mg 3x day)
3. chlorohexidine mouth rinse

Question 18

what are some non-antibacterial effects of tetracyclines
1. conc in ___
2. binds to ___
3. s.r.
4. stimulates ___

Answer 18

• concentrates in GCF
• binds to root surface
• slow release
• stimulates fibroblasts

Question 19

The indication for prescription of an antibiotic is:?
1. Lack of time available to perform mechanical therapy
2. Periodontal abscess formation
3. Patient demands the prescription
4. Systemic spread of infection

Answer 19

4. systemic spread of infection

Question 20

are antibiotics appropriate for abscesses?

Answer 20

maybe

Question 21

if someone has acute periodontal abscesses/ recurrent abscesses with evidence of systemic involvement, are antibiotics indicated?

Answer 21

yes