3. ANTIBIOTICS
Antibiotics are typically
used in medicine to
eliminate infections
caused by the invasion
of the host by a foreign,
pathogenic
microorganism.

4. Why to
administer
antibiotic in
periodontal
Disease???????????

5. The microbial etiology of inflammatory periodontal disease
has provided the basis for the introduction of antibiotics in
their overall management

8. RATIONALE FOR
THE USE OF
ANTIBIOTICS
 Certain specific organisms are closely associated with some forms
of periodontal disease
 All the suspected periodontal pathogens are indigenous to the
oral flora Consequently, the long-term and total
elimination of these organisms with antibiotics will be
very difficult to achieve as immediate repopulation with
the indigenous bacteria will occur when the therapy is
Completed.
 Antibiotics provide a useful adjunct to root planing, which by
itself may not remove all subgingival deposits and certainly
would not affect any invading organisms that had already
penetrated the soft TISSUE.

9. ROUTES OF
ADMINISTRATIO
N
Antibiotics can be administered
 localy
(immediate or controlled release)
 systemically

10. CHOICE OF
ANTIBIOTICS
May be based on microbiological
analysis of the samples obtained from
affected sites
More often, therefore, the choice of
antibiotic is empirical and based on
the clinical signs.

12. Tetracyclines
(doxycycline,
minocycline)
SPECTRUM ROUTE DOSAGE
broad spectrum of Orally, although •The oral dose=
activity against both topical application 1g/day, 250mg
Gram-positive and have been used in tabletes at six-hourly
Gramnegative periodontal intervals
species, although treatment regimens for two weeks
more suitable adjunct to both non-
antibiotics are usually
surgical and surgical
preferred for Gram-
positive infections treatment.
•The oral dose for the
doxycycline and
minocycline is 100-
200mg/day, for 21

13. Metronidazole
SPECTRUM PREPARATION DOSAGE
The antibacterial activity In periodontal •The oral dose
against anaerobic cocci, treatment 750mg/day,
anaerobic Gram -
metronidazole has 250mg tabletes at
negative bacilli, and
been used both in eighthourly intervals
anaerobic Gram - positive
bacilli had led to its use tablet forms, and less for eight days.
in the treatment of
commonly, as a topical •The oral dose for
periodontal disease
metronidazole
application.
+amoxicillin 750
mg/day (for each
drug) for eight days.

14. CLINDAMYCIN
SPECTRUM ROUTE DOSAGE
Clindamycin is oral The oral dose
effective against 900mg/day,
gram-positive 300mg tablets
cocci and at eight-hourly
gram-negative intervals for
anaerobic rods, eight days
adjunct to both
non-surgical and
surgical
treatment.

15. OTHER
ANTIBIOTICS
• The β-lactams, including
amoxicillin, are
broadspectrum drugs that are
frequently prescribed by
periodontists for treating
periodontal abscesses.
•Ciprofloxacin is effective
against several periodontal
pathogens

16. INDICATIONS FOR
ANTIBIOTICS
IN PERIODONTAL
THERAPY
Occasionally, the local infection of a periodontal
abscess can spread within tissue planes to cause
marked facial swelling and systemic involvement
In severe cases both of acute necrotizing
ulcerative gingivitis and periodontitis, especially
if there are signs of systemic involvement.
Multiple abscess formation and gross periodontal
infection would necessiate the administration of
antibiotics (metronidazole and tetracycline)

Antibiotic therapy is warranted in cases of
periodontal disease, which, despite through non-surgical
management and good plaque control, continue to show
breakdown and loss of attachment

17. CONTRAINDICATIONS
AND
UNWANTED EFFECTS
Disease or impaired function of the hepatic or renal
tracts should warrant caution in prescribing systemic
antibiotics.
When penicillins are prescribed it is vitally
important to determine whether or not there is
a history of hypersensitivity to the drug.
The unwanted effects of penicillin are often
mild and characterized by rashes,urticaria,
joint pains, and dermatitis, although severe
anaphylactic reactions have been reported
and can be fatal

18. Resistance to
antibiotic

19. LOCAL
ADMINISTRATION
OF ANTIBIOTIC
 local delivery antibiotics are recommended as adjuncts to
scaling and root debridement, and not as stand-alone
treatments.
fewer side effects, and fewer chances of resistant bacteria
forming
the concentration of the
antibiotic at the diseased site can
be 100 times greater than taking
the medication orally.

20. • Controlled released doxycycline hyclate, 10%
• PerioChip is a thin wafer that contains chlorhexidine.
While chlorhexidine is not an antibiotic, it is a powerful
antiseptic and kills most pathogens. The wafer slides
under the edge of the gum into the pocket.
• Arestin Small spheres of minocycline, a derivative of
tetracycline is very effective in killing the bacteria that are
thought to cause periodontal disease.