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Laforgia A, Inchingolo AD, Piras F, Colonna V, Giorgio RV, Carone C, Rapone B, Malcangi G, Inchingolo AM, Inchingolo F, Palermo A, Dipalma G. Therapeutic Strategies and Genetic Implications for Periodontal Disease Management: A Systematic Review. Int J Mol Sci 2024; 25:7217. [PMID: 39000324 PMCID: PMC11242487 DOI: 10.3390/ijms25137217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 06/23/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
The objective of this review is to identify the microbiological alterations caused by various therapy modalities by critically analyzing the current findings. We limited our search to English-language papers published between 1 January 2004 and 7 May 2024 in PubMed, Scopus, and Web of Science that were relevant to our topic. In the search approach, the Boolean keywords "microbio*" AND "periodontitis" were used. A total of 5152 papers were obtained from the databases Web of Science (2205), PubMed (1793), and Scopus (1154). This resulted in 3266 articles after eliminating duplicates (1886), and 1411 entries were eliminated after their titles and abstracts were examined. The qualitative analysis of the 22 final articles is included in this study. Research on periodontal disease shows that periodontitis alters the oral microbiome and increases antibiotic resistance. Treatments like scaling and root planing (SRP), especially when combined with minocycline, improve clinical outcomes by reducing harmful bacteria. Comprehensive mechanical debridement with antibiotics, probiotics, EMD with bone grafts, and other adjunctive therapies enhances periodontal health. Personalized treatment strategies and advanced microbial analyses are crucial for effective periodontal management and antibiotic resistance control.
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Affiliation(s)
- Alessandra Laforgia
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Valeria Colonna
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Roberto Vito Giorgio
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Claudio Carone
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Andrea Palermo
- College of Medicine and Dentistry, CoMD Birmingham Campus, Birmingham B4 6BN, UK
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
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Frascaroli G, Roberts J, Hunter C, Escudero A. Removal efficiencies of seven frequently detected antibiotics and related physiological responses in three microalgae species. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:14178-14190. [PMID: 38277110 PMCID: PMC10881744 DOI: 10.1007/s11356-024-32026-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/10/2024] [Indexed: 01/27/2024]
Abstract
The main objective of this study is to investigate the effect of mixtures of seven widely used human antibiotics (ciprofloxacin, clarithromycin, erythromycin, metronidazole, ofloxacin, sulfamethoxazole, and trimethoprim) on the growth, pH, pigment production, and antibiotics removal of three microalgal species (Auxenochlorella protothecoides, Tetradesmus obliquus, and Chlamydomonas acidophila). Batch assays were conducted with media with antibiotic mixtures at 10, 50, and 100 μg L-1 for each antibiotic. The three microalgae species effectively removed the antibiotics without any growth inhibition, even when exposed to the highest antibiotic concentrations. Biosorption was reported as the primary mechanism for ciprofloxacin, clarithromycin, metronidazole, and ofloxacin, with up to 70% removal, especially in A. protothecoides and C. acidophila. A. protothecoides, a species never investigated for antibiotic removal, was the only microalgae exhibiting bioaccumulation and biodegradation of specific antibiotics, including sulfamethoxazole. Furthermore, in media with the highest antibiotic concentration, all three species exhibited increased chlorophyll (up to 37%) and carotenoid (up to 32%) production, accompanied by a pH decrease of 3 units. Generally, in the present study, it has been observed that physiological responses and the removal of antibiotics by microalgae are interlinked and contingent on the antibiotic levels and types.
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Affiliation(s)
- Gabriele Frascaroli
- Department of Civil Engineering and Environmental Management, School of Computing, Engineering and Built Environment, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK.
| | - Joanne Roberts
- Department of Applied Science, School of Computing, Engineering and Built Environment, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
| | - Colin Hunter
- Department of Civil Engineering and Environmental Management, School of Computing, Engineering and Built Environment, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
| | - Ania Escudero
- Department of Civil Engineering and Environmental Management, School of Computing, Engineering and Built Environment, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK
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Igo M, Xu L, Krishna A, Stewart S, Xu L, Li Z, Weaver JL, Stone H, Sacks L, Bensman T, Florian J, Rouse R, Han X. A metagenomic analysis for combination therapy of multiple classes of antibiotics on the prevention of the spread of antibiotic-resistant genes. Gut Microbes 2023; 15:2271150. [PMID: 37908118 PMCID: PMC10621307 DOI: 10.1080/19490976.2023.2271150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/11/2023] [Indexed: 11/02/2023] Open
Abstract
Antibiotics used systemically to treat infections may have off-target effects on the gut microbiome, potentially resulting in the emergence of drug-resistant bacteria or selection of pathogenic species. These organisms may present a risk to the host and spread to the environment with a risk of transmission in the community. To investigate the risk of emergent antibiotic resistance in the gut microbiome following systemic treatment with antibiotics, this metagenomic analysis project used next-generation sequencing, a custom-built metagenomics pipeline, and differential abundance analysis to study the effect of antibiotics (ampicillin, ciprofloxacin, and fosfomycin) in monotherapy and different combinations at high and low doses, to determine the effect on resistome and taxonomic composition in the gut of Balb/c mice. The results showed that low-dose monotherapy treatments showed little change in microbiome composition but did show an increase in expression of many antibiotic-resistant genes (ARGs) posttreatment. Dual combination treatments allowed the emergence of some conditionally pathogenic bacteria and some increase in the abundance of ARGs despite a general decrease in microbiota diversity. Triple combination treatment was the most successful in inhibiting emergence of relevant opportunistic pathogens and completely suppressed all ARGs after 72 h of treatment. The relative abundances of mobile genetic elements that can enhance transmission of antibiotic resistance either decreased or remained the same for combination therapy while increasing for low-dose monotherapy. Combination therapy prevented the emergence of ARGs and decreased bacterial diversity, while low-dose monotherapy treatment increased ARGs and did not greatly change bacterial diversity.
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Affiliation(s)
- Matthew Igo
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Lei Xu
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Ashok Krishna
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Sharron Stewart
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Lin Xu
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Zhihua Li
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - James L. Weaver
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Heather Stone
- Office of Medical Policy, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Leonard Sacks
- Office of Medical Policy, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Timothy Bensman
- Division of Infectious Disease Pharmacology, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Jeffry Florian
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Rodney Rouse
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
| | - Xiaomei Han
- Division of Applied Regulatory Science, Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, U. S. Food and Drug Administration, Silver Spring, MD, USA
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Yoon M, Kim E, Seo SH, Kim GU, Choi KY. KY19382 Accelerates Cutaneous Wound Healing via Activation of the Wnt/β-Catenin Signaling Pathway. Int J Mol Sci 2023; 24:11742. [PMID: 37511501 PMCID: PMC10380997 DOI: 10.3390/ijms241411742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
The Wnt/β-catenin signaling pathway plays important roles in the multi-phases of wound healing: homeostasis, inflammation, proliferative, and remodeling phases. However, there are no clinically available therapeutic agents targeting the Wnt/β-catenin pathway. In this study, we tested the effect of 5, 6-dichloroindirubin-3'-methoxime (KY19382), a small molecule that activates the Wnt/β-catenin pathway via interference with the function of the negative feedback regulator CXXC5, on cutaneous wound healing. KY19382 significantly enhanced cell migration of human keratinocytes and dermal fibroblasts with increased levels of β-catenin, phalloidin, Keratin 14, proliferating cell nuclear antigen (PCNA), Collagen I, and alpha-smooth muscle actin (α-SMA) by activating the Wnt/β-catenin signaling pathway without causing significant cytotoxicity. In addition, levels of Collagen I, Keratin 14, PCNA, and stem cell markers were significantly increased by KY19382 in a cutaneous murine wound healing model. Moreover, KY19382 treatment accelerated re-epithelialization and neo-epidermis formation with collagen deposition and stem cell activation at an early stage of cutaneous wound healing. Overall, KY19382 accelerates wound healing via activating the Wnt/β-catenin pathway, and may have the potential to be used for the development of a new wound healing agent.
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Affiliation(s)
- Minguen Yoon
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul 03722, Republic of Korea
| | - Eunhwan Kim
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul 03722, Republic of Korea
| | - Seol Hwa Seo
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul 03722, Republic of Korea
| | - Geon-Uk Kim
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul 03722, Republic of Korea
| | - Kang-Yell Choi
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul 03722, Republic of Korea
- CK Regeon Inc., Seoul 03722, Republic of Korea
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Euodia daniellii Hemsl. Extract and Its Active Component Hesperidin Accelerate Cutaneous Wound Healing via Activation of Wnt/β-Catenin Signaling Pathway. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27207134. [PMID: 36296727 PMCID: PMC9608813 DOI: 10.3390/molecules27207134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/06/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
The activation of the Wnt/β-catenin signaling pathway plays a key role in the wound-healing process through tissue regeneration. The extract of Euodia daniellii Hemsl. (E. daniellii), a member of the Rutaceae family, activates the Wnt/β-catenin signaling pathway. However, the function of E. daniellii in wound healing has not yet been elucidated. We performed a migration assay to determine the wound-healing effect of E. daniellii extract in vitro using human keratinocytes and dermal fibroblast. In addition, a mouse acute wound model was used to investigate the cutaneous wound-healing effect of E. daniellii extract in vivo and confirm the potential mechanism. E. daniellii extract enhanced the migration of human keratinocytes and dermal fibroblasts via the activation of the Wnt/β-catenin pathway. Moreover, the E. daniellii extract increased the levels of keratin 14, PCNA, collagen I, and α-SMA, with nuclei accumulation of β-catenin in vitro. E. daniellii extract also efficiently accelerated re-epithelialization and stimulated wound healing in vivo. Furthermore, we confirmed that hesperidin, one of the components of E. daniellii, efficiently accelerated the migration of human keratinocytes and dermal fibroblasts, as well as wound healing in vivo via the activation of the Wnt/β-catenin pathway. Overall, E. daniellii extract and its active component, hesperidin, have potential to be used as therapeutic agents for wound healing.
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Alshaer M, Mazirka P, Burch G, Peloquin C, Drabick Z, Carson J. Experience with Implementing a Beta-lactam Therapeutic Drug Monitoring Service in a Burn Intensive Care Unit: A Retrospective Chart Review. J Burn Care Res 2022; 44:121-128. [PMID: 35896122 PMCID: PMC9825314 DOI: 10.1093/jbcr/irac099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Indexed: 01/13/2023]
Abstract
Thermal injuries alter pharmacokinetics, complicating the prediction of standard antibiotic dose effectiveness. Therapeutic drug monitoring (TDM) has been proposed to prevent subtherapeutic dosing of antibiotic therapy, but remains scarcely studied in the burn patient population. A retrospective chart review of burn patients receiving beta-lactam TDM from 2016 to 2019 was conducted. Adult patients with thermal injury receiving cefepime, piperacillin/tazobactam, or meropenem for ≥48 hours were included. Between February 2016 and July 2017, we utilized selective TDM based on clinical judgement to guide treatment. From October 2018 until July 2019, TDM was expanded to all burn patients on beta-lactams. The primary endpoint was achievement of therapeutic concentration, and the secondary endpoints were clinical cure, culture clearance, new resistance, length of stay, and mortality. The selective (control) group included 19 patients and the universal (study) group reviewed 23 patients. In both groups, skin and lungs were the most common primary infection sources, with Pseudomonas aeruginosa as the most common species. In the universal cohort, patients were older with higher risk factors, but more frequently achieved the target drug concentration, required less days to start TDM (p < .0001), and had more frequent measurements and beta-lactam dose adjustments. Positive clinical outcome was reported in 77%, and microbial eradication in 82% of all patients. All clinical outcomes were similar between the groups. The implementation of beta-lactam TDM protocol shortened the time, increased the probability of appropriate target attainment, and individualized beta-lactam therapy in burn patients.
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Affiliation(s)
- Mohammad Alshaer
- Infectious Disease Pharmacokinetics Laboratory College of Pharmacy, and Emerging Pathogens Institute, University of Florida, Gainesville, USA
| | - Pavel Mazirka
- Address Correspondence to: Pavel Mazirka, MD, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Rd., PO Box 100287, Gainesville, FL 32608, USA.
| | - Gena Burch
- College of Pharmacy and Emerging Pathogens Institute, University of Florida, Gainesville, USA
| | - Charles Peloquin
- College of Pharmacy and Emerging Pathogens Institute, University of Florida, Gainesville, USA
| | - Zachary Drabick
- College of Pharmacy and Emerging Pathogens Institute, University of Florida, Gainesville, USA
| | - Joshua Carson
- The Loyola Burn Center, Loyola University Medical Center, Maywood, Illinois, USA
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Bobrovsky PA, Moroz VD, Lavrenova VN, Manuvera VA, Lazarev VN. Inhibition of Chlamydial Infection by CRISPR/Cas9-SAM Mediated Enhancement of Human Peptidoglycan Recognition Proteins Gene Expression in HeLa Cells. BIOCHEMISTRY (MOSCOW) 2021; 85:1310-1318. [PMID: 33280575 DOI: 10.1134/s0006297920110036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The global problem of emerging resistance of microorganisms to antibiotics makes the search for new natural substances with antibacterial properties relevant. Such substances include peptidoglycan recognition proteins (PGLYRP), which are the components of the innate immunity of many organisms, including humans. These proteins have a unique mechanism of action that allows them to evade the resistance of bacteria to them, as well as to be active against both Gram-positive and Gram-negative bacteria. However, the use of antimicrobial recombinant proteins is not always advisable due to the complexity of local delivery of the proteins and their stability; in this regard it seems appropriate to activate the components of the innate immunity. The aim of this study was to increase the expression level of native peptidoglycan recognition protein genes in HeLa cells using genome-editing technology with synergistic activation mediators (CRISPR/Cas9-SAM) and evaluate antichlamydial effect of PGLYRP. We demonstrated activation of the chlamydial two-component gene system (ctcB-ctcC), which played a key role in the mechanism of action of the peptidoglycan recognition proteins. We generated the HeLa cell line transduced with lentiviruses encoding CRISPR/Cas9-SAM activation system with increased PGLYRP gene expression. It was shown that activation of the own peptidoglycan recognition proteins gene expression in the cell line caused inhibition of the chlamydial infection development. The proposed approach makes it possible to use the capabilities of innate immunity to combat infectious diseases caused by Gram-positive and Gram-negative bacteria.
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Affiliation(s)
- P A Bobrovsky
- Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, 119435, Russia.
| | - V D Moroz
- Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, 119435, Russia
| | - V N Lavrenova
- Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, 119435, Russia.,Faculty of Biology, Lomonosov Moscow State University, Moscow, 119991, Russia
| | - V A Manuvera
- Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, 119435, Russia
| | - V N Lazarev
- Federal Research and Clinical Center of Physical-Chemical Medicine of Federal Medical Biological Agency, Moscow, 119435, Russia
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Pancu DF, Scurtu A, Macasoi IG, Marti D, Mioc M, Soica C, Coricovac D, Horhat D, Poenaru M, Dehelean C. Antibiotics: Conventional Therapy and Natural Compounds with Antibacterial Activity-A Pharmaco-Toxicological Screening. Antibiotics (Basel) 2021; 10:401. [PMID: 33917092 PMCID: PMC8067816 DOI: 10.3390/antibiotics10040401] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/11/2022] Open
Abstract
Antibiotics are considered as a cornerstone of modern medicine and their discovery offers the resolution to the infectious diseases problem. However, the excessive use of antibiotics worldwide has generated a critical public health issue and the bacterial resistance correlated with antibiotics inefficiency is still unsolved. Finding novel therapeutic approaches to overcome bacterial resistance is imperative, and natural compounds with antibacterial effects could be considered a promising option. The role played by antibiotics in tumorigenesis and their interrelation with the microbiota are still debatable and are far from being elucidated. Thus, the present manuscript offers a global perspective on antibiotics in terms of evolution from a historical perspective with an emphasis on the main classes of antibiotics and their adverse effects. It also highlights the connection between antibiotics and microbiota, focusing on the dual role played by antibiotics in tumorigenesis. In addition, using the natural compounds with antibacterial properties as potential alternatives for the classical antibiotic therapy is discussed.
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Affiliation(s)
- Daniel Florin Pancu
- Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 1, 300041 Timisoara, Romania; (D.F.P.); (D.H.); (M.P.)
| | - Alexandra Scurtu
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.S.); (M.M.); (C.S.); (D.C.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Ioana Gabriela Macasoi
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.S.); (M.M.); (C.S.); (D.C.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Daniela Marti
- Faculty of Medicine, Western University Vasile Goldis Arad, 94 Revolutiei Blvd., 310025 Arad, Romania
| | - Marius Mioc
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.S.); (M.M.); (C.S.); (D.C.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Codruta Soica
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.S.); (M.M.); (C.S.); (D.C.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Dorina Coricovac
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.S.); (M.M.); (C.S.); (D.C.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Delia Horhat
- Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 1, 300041 Timisoara, Romania; (D.F.P.); (D.H.); (M.P.)
| | - Marioara Poenaru
- Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 1, 300041 Timisoara, Romania; (D.F.P.); (D.H.); (M.P.)
| | - Cristina Dehelean
- Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (A.S.); (M.M.); (C.S.); (D.C.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
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Qin JP, Huang HB, Zhou H, Zhu Y, Xu Y, Du B. Amikacin nebulization for the adjunctive therapy of gram-negative pneumonia in mechanically ventilated patients: a systematic review and meta-analysis of randomized controlled trials. Sci Rep 2021; 11:6969. [PMID: 33772055 PMCID: PMC7997905 DOI: 10.1038/s41598-021-86342-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/08/2021] [Indexed: 12/29/2022] Open
Abstract
Treatment of ventilated patients with gram-negative pneumonia (GNP) is often unsuccessful. We aimed to assess the efficacy and safety of nebulized amikacin (NA) as adjunctive therapy to systemic antibiotics in this patient population. PubMed, Embase, China national knowledge infrastructure, Wanfang, and the Cochrane database were searched for randomized controlled trials (RCTs) investigating the effect of NA as adjunctive therapy in ventilated adult patients with GNP. Heterogeneity was explored using subgroup analysis and sensitivity analysis. The Grading of recommendations assessment, development, and evaluation approach was used to assess the certainty of the evidence. Thirteen RCTs with 1733 adults were included. The pooled results showed NA had better microbiologic eradication (RR = 1.51, 95% CI 1.35 to 1.69, P < 0.0001) and improved clinical response (RR = 1.23; 95% CI 1.13 to 1.34; P < 0.0001) when compared with control. Meanwhile, overall mortality, pneumonia associated mortality, duration of mechanical ventilation, length of stay in ICU and change of clinical pneumonia infection scores were similar between NA and control groups. Additionally, NA did not add significant nephrotoxicity while could cause more bronchospasm. The use of NA adjunctive to systemic antibiotics therapy showed better benefits in ventilated patients with GNP. More well-designed RCTs are still needed to confirm our results.
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Affiliation(s)
- Jun-Ping Qin
- Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China
| | - Hui-Bin Huang
- Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China.
| | - Hua Zhou
- Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China
| | - Yuan Zhu
- Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China
| | - Yuan Xu
- Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China
| | - Bin Du
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 1 Shuai Fu Yuan, Beijing, 100730, China
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10
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Does Curcumin Have an Anticaries Effect? A Systematic Review of In Vitro Studies. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1291:213-227. [PMID: 34331692 DOI: 10.1007/978-3-030-56153-6_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Dental caries is one of the most important oral health problems and a common infectious microbial disease. Streptococcus mutans (S. mutans) has been regarded as the primary etiologic factor in the formation of dental caries. Curcumin (CUR) has an antibacterial action and could be used in the eradication of S. mutans to control dental caries. This systematic review was undertaken with the aim of evaluating the anticaries effect of CUR. METHODS A comprehensive search was conducted in the PubMed/Medline, Cochrane - CENTRAL, and Scopus databases. Based on the PICO model, studies which evaluated the anticaries effects of CUR up until 24 February 2020 with language restrictions were selected for this systematic review. RESULTS From 753 papers found, 13 met the eligibility criteria and were included. In 12 out of 13 included studies, CUR had significant antibacterial and anticaries effects. CUR had inhibitory effects on S. mutans growth, acid production, ATPase and sortase A activity, biomass, viability and metabolism reduction of biofilm, reduced exopolysaccharide production of biofilms, changes in biofilm structure, and had anti-adhesion effects against S. mutans. CONCLUSION This systematic review suggests promising antibacterial and anticaries effects of CUR including inhibition of S. mutans growth, acid production, ATPase and sortase A activity. This review provides unique information regarding the potential role of CUR in the prevention and treatment of dental carries as a natural, accessible, safe, and inexpensive agent to increase oral and dental health. However, clinical randomized controlled trials are needed to confirm these results.
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Al-Kattan R, Al-Shibani N. Current trends in antibiotic prescription behavior among Saudi dentists performing implant surgery: A cross-sectional observational study. ACTA ACUST UNITED AC 2018; 10:e12383. [PMID: 30556379 DOI: 10.1111/jicd.12383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022]
Abstract
AIM The aim of the present study was to investigate current trends in antibiotic prescription behavior among dentists performing implant surgery. METHODS A cross-sectional observational study was conducted among 133 dental specialists in Saudi Arabia. A self-administered questionnaire comprising of 21 questions related to basic demographic details (ie, sex, age, nationality, undergraduate training, type of specialty, clinical, and implant practice experience) made up the first part of the questionnaire. The second part of the questionnaire consisted of 12 close-ended questions concerning knowledge and opinions of the dental specialists related to antibiotic prescription patterns pre- or post-implant surgeries. Data were compiled and analyzed using SPSS version 20. Descriptive statistics were employed to calculate the means and percentages for demographic data and preoperative and postoperative antibiotic-prescribing habits in dental implant placement. RESULTS All practicing dentists prescribed antibiotics preoperatively prior to routine dental implant placement; 41.4% (N = 55) of participants were in favor of recommending antibiotics after routine dental implant placement (postoperatively). CONCLUSION Antibiotic-prescribing patterns in implant surgery among Saudi dentists are diverse and inconsistent. Further studies are required to investigate the effect of prophylactic antibiotics in lowering the risk of implant failure.
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Affiliation(s)
- Reem Al-Kattan
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nouf Al-Shibani
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
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Formulation of thermoreversible gel of cranberry juice concentrate: Evaluation, biocompatibility studies and its antimicrobial activity against periodontal pathogens. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 75:1506-1514. [DOI: 10.1016/j.msec.2017.03.054] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 03/02/2017] [Accepted: 03/06/2017] [Indexed: 01/08/2023]
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Li H, Ji Q, Chen X, Sun Y, Xu Q, Deng P, Hu F, Yang J. Accelerated bony defect healing based on chitosan thermosensitive hydrogel scaffolds embedded with chitosan nanoparticles for the delivery of BMP2 plasmid DNA. J Biomed Mater Res A 2016; 105:265-273. [PMID: 27636714 DOI: 10.1002/jbm.a.35900] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/27/2016] [Accepted: 09/13/2016] [Indexed: 01/13/2023]
Affiliation(s)
- Hui Li
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
- Department of Stomatology; Beijing Tongzhou Xinhua Hospital; Tongzhou Beijing 101100 China
| | - Qiuxia Ji
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Ximin Chen
- Orthopedic Center; Qilu Hospital of Shandong University; Qingdao Shandong 266035 China
| | - Yan Sun
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Quanchen Xu
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Panpan Deng
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Fang Hu
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Jianjun Yang
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
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Lourenço TGB, Heller D, do Souto RM, Silva-Senem MXE, Varela VM, Torres MCB, Feres-Filho EJ, Colombo APV. Long-term evaluation of the antimicrobial susceptibility and microbial profile of subgingival biofilms in individuals with aggressive periodontitis. Braz J Microbiol 2015; 46:493-500. [PMID: 26273264 PMCID: PMC4507541 DOI: 10.1590/s1517-838246220131037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 11/11/2014] [Indexed: 11/23/2022] Open
Abstract
This study evaluates the antimicrobial susceptibility and composition of
subgingival biofilms in generalized aggressive periodontitis (GAP) patients
treated using mechanical/antimicrobial therapies, including chlorhexidine (CHX),
amoxicillin (AMX) and metronidazole (MET). GAP patients allocated to the placebo
(C, n = 15) or test group (T, n = 16) received full-mouth disinfection with CHX,
scaling and root planning, and systemic AMX (500 mg)/MET (250 mg) or placebos.
Subgingival plaque samples were obtained at baseline, 3, 6, 9 and 12 months
post-therapy from 3–4 periodontal pockets, and the samples were pooled and
cultivated under anaerobic conditions. The minimum inhibitory concentrations
(MICs) of AMX, MET and CHX were assessed using the microdilution method.
Bacterial species present in the cultivated biofilm were identified by
checkerboard DNA-DNA hybridization. At baseline, no differences in the MICs
between groups were observed for the 3 antimicrobials. In the T group,
significant increases in the MICs of CHX (p < 0.05) and AMX (p < 0.01)
were detected during the first 3 months; however, the MIC of MET decreased at 12
months (p < 0.05). For several species, the MICs significantly changed over
time in both groups, i.e., Streptococci MICs
tended to increase, while for several periodontal pathogens, the MICs
diminished. A transitory increase in the MIC of the subgingival biofilm to AMX
and CHX was observed in GAP patients treated using enhanced mechanical therapy
with topical CHX and systemic AMX/MET. Both protocols presented limited effects
on the cultivable subgingival microbiota.
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Affiliation(s)
- Talita Gomes Baêta Lourenço
- Universidade Federal do Rio de Janeiro, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Brazil
| | - Débora Heller
- Universidade Federal do Rio de Janeiro, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Brazil. ; Universidade Federal do Rio de Janeiro, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Brazil. ; Boston University, Oral Biology Departament, Goldman School of Medicine, Boston, MA, USA, Oral Biology Departament, Goldman School of Medicine, Boston, MA, USA
| | - Renata Martins do Souto
- Universidade Federal do Rio de Janeiro, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Brazil
| | - Mayra Xavier E Silva-Senem
- Universidade Federal do Rio de Janeiro, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Brazil
| | - Victor Macedo Varela
- Universidade Federal do Rio de Janeiro, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Brazil
| | - Maria Cynesia Barros Torres
- Universidade Federal do Rio de Janeiro, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Brazil
| | - Eduardo Jorge Feres-Filho
- Universidade Federal do Rio de Janeiro, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Brazil
| | - Ana Paula Vieira Colombo
- Universidade Federal do Rio de Janeiro, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Brazil. ; Universidade Federal do Rio de Janeiro, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil, Departamento de Clínica Dentária, Universidade Federal do Rio de Janeiro, Brazil
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Juiz PJL, Lucchese AM, Gambari R, Piva R, Penolazzi L, Di Ciano M, Uetanabaro APT, Silva F, Avila-Campos MJ. Essential oils and isolated compounds from Lippia alba leaves and flowers: antimicrobial activity and osteoclast apoptosis. Int J Mol Med 2014; 35:211-7. [PMID: 25384405 DOI: 10.3892/ijmm.2014.1995] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 10/24/2014] [Indexed: 11/05/2022] Open
Abstract
In the present study, essential oils extracted from the leaves and flowers of Lippia alba (Mill.) N.E.Br. (L. alba) were analyzed for their antimicrobial activity and their effects on osteoclasts. The periodontal pathogens, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans; ATCC 43717), Fusobacterium nucleatum (F. nucleatum; ATCC 25586) and Porphyromonas gingivalis (P. gingivalis); ATCC 33277) were used in antimicrobial activity assays for determining the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC), whereas Bacteroides fragilis (B. fragilis; ATCC 25285) was used as the control microorganism. Osteoclast (OC) apoptosis was assessed by TUNEL assay and Fas receptor expression was detected by immunocytochemistry. The analysis of antimicrobial activity revealed that P. gingivalis had the lowest MIC values, whereas A. actinomycetemcomitans had the highest. L. alba essential oils were found to be toxic to human cells, although the compounds, carvone, limonene and citral, were non-toxic and induced apoptosis in the OCs. This study demonstrates that L. alba has potential biotechnological application in dentistry. In fact periodontal disease has a multifactorial etiology, and the immune response to microbial challenge leads to osteoclast activation and the resorption of the alveolar bone, resulting in tooth loss.
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Affiliation(s)
- Paulo José Lima Juiz
- Center for Health Sciences, Federal University of Recôncavo da Bahia, Cajueiro, 44570-000 Santo Antônio de Jesus, Bahia, Brazil
| | - Angelica Maria Lucchese
- Department of Mathematical Sciences, Area of Chemistry, State University of Feira de Santana, 44031-460 Feira de Santana, Bahia, Brazil
| | - Roberto Gambari
- Department of Life Sciences and Biotechnology, University of Ferrara, 44121 Ferrara, Italy
| | - Roberta Piva
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Letizia Penolazzi
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Martina Di Ciano
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Ana Paula Trovatti Uetanabaro
- Department of Biological Sciences - UESC, State University of Santa Cruz, Salobrinho, 45662900 Ilheus, Bahia, Brazil
| | - Franceli Silva
- Center for Agricultural, Environmental and Biological Sciences, Federal University of Recôncavo da Bahia, 44380-000 Cruz das Almas, Bahia, Brazil
| | - Mario Julio Avila-Campos
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, 05508-900 Butantan, São Paulo, Brazil
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Vieira DRP, Amaral FM, Maciel MCG, Nascimento FRF, Libério SA, Rodrigues VP. Plant species used in dental diseases: ethnopharmacology aspects and antimicrobial activity evaluation. JOURNAL OF ETHNOPHARMACOLOGY 2014; 155:1441-1449. [PMID: 25046828 DOI: 10.1016/j.jep.2014.07.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 07/08/2014] [Accepted: 07/11/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ethnopharmacological surveys show that several plant species are used empirically by the population, in oral diseases. However, it is necessary to check the properties of these plant species. AIM OF THE STUDY To evaluate in vitro antimicrobial activity against Streptococcus mutans from plant species selected in a previous ethnopharmacology study. MATERIALS AND METHODS An ethnopharmacological survey was conducted with users of a dental clinic school services, located in Sao Luis, Maranhão, Brazil, aiming to identify plant species used in oral diseases treatment. From the ethnopharmacological survey, species were selected for in vitro antimicrobial activity evaluation against Streptococcus mutans, by agar diffusion method and determination of Minimum Inhibitory Concentration (MIC). RESULTS Two hundred and seventy one people participated in the research: 55.7% reported the use of plants for medicinal purposes, 29.5% of which have knowledge and/or use plants for some type of oral disease. Thirty four species belonging to 24 (twenty four) botanical families were reported, being Aloe vera L., Anacardium occidentale L., Schinus terebinthifolius Raddi, Chenopodium ambrosioides L. and Punica granatum L. the most cited. The most commonly reported indications were healing after tooth extraction, followed by toothache, inflammation and bleeding gums., The determination of Minimum Inhibitory Concentration (MIC) demonstrated that Punica granatum L., Psidium guajava L. and Schinus terebinthifolius Raddi showed similar activity to 0.12% chlorhexidine, used as positive control. CONCLUSION That result is important to follow up the study of these species in the search for new anticariogenic agents originated by plants.
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Affiliation(s)
- Denise R P Vieira
- Federal University of Maranhão, Bacanga Campus, Portugueses Avenue, s/n, Odontology Building, 65085-580 São Luís, Maranhão, Brazil.
| | - Flavia MaM Amaral
- Federal University of Maranhão, Bacanga Campus, Portugueses Avenue, s/n, Pharmacy Building, 65085-580 São Luís, Maranhão, Brazil
| | - Márcia C G Maciel
- Federal University of Maranhão, Bacanga Campus, Portugueses Avenue, s/n, Immune Physiology Laboratory, 65085-580 São Luís, Maranhão, Brazil
| | - Flávia R F Nascimento
- Federal University of Maranhão, Bacanga Campus, Portugueses Avenue, s/n, Immune Physiology Laboratory, 65085-580 São Luís, Maranhão, Brazil
| | - Silvana A Libério
- Federal University of Maranhão, Bacanga Campus, Portugueses Avenue, s/n, Odontology Building, 65085-580 São Luís, Maranhão, Brazil
| | - Vandílson P Rodrigues
- Federal University of Maranhão, Bacanga Campus, Portugueses Avenue, s/n, Odontology Building, 65085-580 São Luís, Maranhão, Brazil
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Fysal N, Jose S, Kulshrestha R, Arora D, Hafiz KA, Vasudevan S. Antibiogram pattern of oral microflora in periodontic children of age group 6 to 12 years: a clinicomicrobiological study. J Contemp Dent Pract 2013; 14:595-600. [PMID: 24309334 DOI: 10.5005/jp-journals-10024-1370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The study was carried out to see the diversity of oral microflora and its antibiotic sensitivity test in children of age group 6 to 12 years was carried. MATERIALS AND METHODS Total 50 patients of age group 6 to 12 years were analyzed for their oral microflora and then checked for the antibiotic susceptibility test. The samples that were collected were incubated at 37°C for 48 hours. Once dispersed samples were taken and Gram staining was done, also they were spread on to a number of freshly prepared agar plates and incubated to allow cells to form microbial colony. RESULTS The result showed microflora common in all types, Gram-positive facultative anaerobic rods and cocci. In normal children Gram-positive facultative anaerobic and fermenting cocci were predominant where as in children with caries growth of microbiota that were Gram-negative and positive, capnophilic, motile and anaerobic rods and cocci belonging to members of genera S. mutans and A. actinomycetemcomitans was seen. CONCLUSION By the present study it has been concluded that the number of bacteria determined by microscopic counts was twice as high in caries patients as in healthy sites, and also recommended that amoxicillin, ampicillin and amikacin are the most effective antibacterial drugs for the treatment of dental caries.
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Affiliation(s)
- N Fysal
- Associate Professor, Department of Pediatrics, MES Medical College Palachode, Kerala, India
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Soares GMS, Figueiredo LC, Faveri M, Cortelli SC, Duarte PM, Feres M. Mechanisms of action of systemic antibiotics used in periodontal treatment and mechanisms of bacterial resistance to these drugs. J Appl Oral Sci 2013; 20:295-309. [PMID: 22858695 PMCID: PMC3881775 DOI: 10.1590/s1678-77572012000300002] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 09/20/2011] [Indexed: 11/22/2022] Open
Abstract
Antibiotics are important adjuncts in the treatment of infectious diseases, including periodontitis. The most severe criticisms to the indiscriminate use of these drugs are their side effects and, especially, the development of bacterial resistance. The knowledge of the biological mechanisms involved with the antibiotic usage would help the medical and dental communities to overcome these two problems. Therefore, the aim of this manuscript was to review the mechanisms of action of the antibiotics most commonly used in the periodontal treatment (i.e. penicillin, tetracycline, macrolide and metronidazole) and the main mechanisms of bacterial resistance to these drugs. Antimicrobial resistance can be classified into three groups: intrinsic, mutational and acquired. Penicillin, tetracycline and erythromycin are broad-spectrum drugs, effective against gram-positive and gram-negative microorganisms. Bacterial resistance to penicillin may occur due to diminished permeability of the bacterial cell to the antibiotic; alteration of the penicillin-binding proteins, or production of β-lactamases. However, a very small proportion of the subgingival microbiota is resistant to penicillins. Bacteria become resistant to tetracyclines or macrolides by limiting their access to the cell, by altering the ribosome in order to prevent effective binding of the drug, or by producing tetracycline/macrolide-inactivating enzymes. Periodontal pathogens may become resistant to these drugs. Finally, metronidazole can be considered a prodrug in the sense that it requires metabolic activation by strict anaerobe microorganisms. Acquired resistance to this drug has rarely been reported. Due to these low rates of resistance and to its high activity against the gram-negative anaerobic bacterial species, metronidazole is a promising drug for treating periodontal infections.
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Affiliation(s)
- Geisla Mary Silva Soares
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, SP, Brazil
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Mombelli A, Cionca N, Almaghlouth A. Does adjunctive antimicrobial therapy reduce the perceived need for periodontal surgery? Periodontol 2000 2010; 55:205-16. [DOI: 10.1111/j.1600-0757.2010.00356.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Ji QX, Deng J, Xing XM, Yuan CQ, Yu XB, Xu QC, Yue J. Biocompatibility of a chitosan-based injectable thermosensitive hydrogel and its effects on dog periodontal tissue regeneration. Carbohydr Polym 2010. [DOI: 10.1016/j.carbpol.2010.06.045] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kouidhi B, Zmantar T, Hentati H, Najjari F, Mahdouni K, Bakhrouf A. Molecular investigation of macrolide and Tetracycline resistances in oral bacteria isolated from Tunisian children. Arch Oral Biol 2010; 56:127-35. [PMID: 20950793 DOI: 10.1016/j.archoralbio.2010.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 09/03/2010] [Accepted: 09/13/2010] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aims to investigate the antibiotic susceptibility of strains isolated from the oral cavity of Tunisian children. DESIGN Strains were isolated from the oral cavity of Tunisian children (60 caries-actives and 30 caries-free). Molecular characterization was assessed by PCR assay to detect erythromycin methylase gene (ermB), macrolide efflux (mefI) and tetracycline resistance genes (tetM and tetO). RESULTS A total of 21 species were isolated and identified. Antimicrobial susceptibility revealed that the resistance rate to antibiotics was as follow: erythromycin (22%), tetracycline (15.6%), cefotaxim, (7.3%), trimethoprim-sulfamethoxazol (37.6%), nitrofurantoine (2.8%), pristinamycin (17.4%), quinupristin-dalfopristin (15.6%), and rifampicin (3.7%). The majority of mefI positive strains (31.2%) were isolated from the carious children (n=34) in comparison with 8.25% from the control group (n=9). In addition, frequency of strains caring resistance genes were as follow: 12.84% for ermB, 9.17% for tetM and 27.52% for tetO from the carious children in comparison to 0.092%, 3.67% and 3.67% from the caries free group respectively. CONCLUSION Multi-resistance strains towards macrolides and tetracycline were recorded. The majority of strains carrying antibiotics resistance genes were isolated from the caries active children. The presence of multi-resistant bacteria in the oral cavity can be the major cause of antibiotic prophylaxis failure in dental practise.
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Affiliation(s)
- Bochra Kouidhi
- Laboratoire d'Analyses, Traitement et Valorisation des Polluants de l'Environnement et des Produits, Faculté de Pharmacie de Monastir, Biologie Clinique, Rue Avicenne, 5000 Monastir, Tunisie.
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Williams FN, Herndon DN, Hawkins HK, Lee JO, Cox RA, Kulp GA, Finnerty CC, Chinkes DL, Jeschke MG. The leading causes of death after burn injury in a single pediatric burn center. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2009; 13:R183. [PMID: 19919684 PMCID: PMC2811947 DOI: 10.1186/cc8170] [Citation(s) in RCA: 213] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 10/30/2009] [Accepted: 11/17/2009] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Severe thermal injury is characterized by profound morbidity and mortality. Advances in burn and critical care, including early excision and grafting, aggressive resuscitation and advances in antimicrobial therapy have made substantial contributions to decrease morbidity and mortality. Despite these advances, death still occurs. Our aim was to determine the predominant causes of death in burned pediatric patients in order to develop new treatment avenues and future trajectories associated with increased survival. METHODS Primary causes of death were reviewed from 144 pediatric autopsy reports. Percentages of patients that died from anoxic brain injuries, sepsis, or multi-organ failure were calculated by comparing to the total number of deaths. Data was stratified by time (from 1989 to 1999, and 1999 to 2009), and gender. Statistical analysis was done by chi-squared, Student's t-test and Kaplan-Meier for survival where applicable. Significance was accepted as P < 0.05. RESULTS Five-thousand two-hundred-sixty patients were admitted after burn injury from July 1989 to June 2009, and of those, 145 patients died after burn injury. Of these patients, 144 patients had an autopsy. The leading causes of death over 20 years were sepsis (47%), respiratory failure (29%), anoxic brain injury (16%), and shock (8%). From 1989 to 1999, sepsis accounted for 35% of deaths but increased to 54% from 1999 to 2009, with a significant increase in the proportion due to antibiotic resistant organisms (P < 0.05). CONCLUSIONS Sepsis is the leading cause of death after burn injury. Multiple antibiotic resistant bacteria now account for the bulk of deaths due to sepsis. Further improvement in survival may require improved strategies to deal with this problem.
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Affiliation(s)
- Felicia N Williams
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas 77555, USA.
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Bosco JMD, Oliveira SRD, Bosco ÁF, Schweitzer CM, Jardim Júnior EG. Influence of local tetracycline on the microbiota of alveolar osteitis in rats. Braz Dent J 2008; 19:119-23. [DOI: 10.1590/s0103-64402008000200006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to evaluate the effects of local tetracycline on the occurrence of alveolar osteitis in rats, and on the microbiota associated to this infection. Forty Wistar rats were randomly assigned to 4 groups (n=10): I - the rats had the maxillary right incisor extracted and the alveolar wound did not receive any treatment; II - adrenaline and Ringer-PRAS were introduced into the alveolar wound; III - the alveolar wound was irrigated with sterile saline; and IV - the alveolar wound was irrigated with an aqueous solution of tetracycline. Microbial samples from the alveolar wounds were collected 2 days after surgery and inoculated on blood agar (with and without 8 µg/mL of tetracycline) and other selective media, and were incubated in either aerobiosis or anaerobiosis at 37ºC, for 2 to 14 days. It was verified that tetracycline reduced the occurrence of alveolar osteitis in the rats and caused significant changes in the microbiota of the surgical sites, decreasing the number of anaerobes and increasing the participation of tetracycline-resistant and multi-resistant microorganisms.
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Li H, Lin XM, Wang SY, Peng XX. Identification and Antibody-Therapeutic Targeting of Chloramphenicol-Resistant Outer Membrane Proteins in Escherichia coli. J Proteome Res 2007; 6:3628-36. [PMID: 17711325 DOI: 10.1021/pr070307y] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Bacterial resistance to an antibiotic may result from survival in a suddenly strong antibiotic or in sub-minimum inhibitory concentration of the drug. Their shared proteins responsible for the resistance should be potential targets for designing new drugs to inhibit the growth of the antibiotic-resistant bacteria. In the current study, comparative proteomic methodologies were used for identification of sharedly altered outer membrane proteins (OM proteins) that are responsible for chloramphenical (CAP)-resistant Escherichia coli and for survival in medium with suddenly strong CAP treatment. Six differential OM proteins and another protein with unknown location were determined to be sharedly CAP-resistant-related proteins with the use of 2-DE/MS, Western blotting and gene mutant methods, in which TolC, OmpT, OmpC, and OmpW were critically altered proteins and potential targets for designing of the new drugs. Furthermore, a novel method of specific antibody combating bacterial growth was developed on these OM proteins. Only anti-TolC showed a very significant inhibition on bacterial growth in medium with CAP when antisera to TolC, OmpC, OmpT, and OmpW were separately utilized. The growth of CAP-resistant E. coli and its original strain was completely inhibited when they bound with anti-TolC and survived in 1/8 MIC of CAP. This observed result is basically the same to the finding that DeltatolC was survived in the same concentration of the antibiotic. Our study demonstrates that the enhancement of expression of antibody target with antibiotic could be very effective approach compared to using a drug alone, which highlights a potential way for treatment of infection by antibiotic-resistant bacteria.
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Affiliation(s)
- Hui Li
- State key Laboratory of Biocontrol, School of Life Sciences, Zhongshan University, Guangzhou, 510275, People Republic of China
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Ready D, Pratten J, Roberts AP, Bedi R, Mullany P, Wilson M. Potential role of Veillonella spp. as a reservoir of transferable tetracycline resistance in the oral cavity. Antimicrob Agents Chemother 2006; 50:2866-8. [PMID: 16870789 PMCID: PMC1538667 DOI: 10.1128/aac.00217-06] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Twelve out of 96 Veillonella spp. isolated from oral samples harbored tetracycline resistance genes. The most common resistance gene was tet(M). A tet(M)-positive Veillonella dispar strain was shown to transfer a Tn916-like element to four Streptococcus spp. by conjugation at a frequency of 5.2 x 10(-6) to 4.5 x 10(-5) per recipient.
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Affiliation(s)
- D Ready
- Microbiology, Eastman Dental Hospital, UCLH NHS Foundation Trust, London WC1X 8LD, UK.
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Almaguer-Flores A, Moreno-Borjas JY, Salgado-Martinez A, Sanchez-Reyes MA, Alcantara-Maruri E, Ximenez-Fyvie LA. Proportion of antibiotic resistance in subgingival plaque samples from Mexican subjects. J Clin Periodontol 2006; 33:743-8. [PMID: 16899025 DOI: 10.1111/j.1600-051x.2006.00975.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To determine the proportion of bacteria resistant to amoxicillin and doxycycline in subgingival plaque samples from Mexican subjects. MATERIALS AND METHODS Two subgingival plaque samples were taken from 20 Mexican subjects. Samples were dispersed, diluted and plated on non-antibiotic agar plates and on plates containing 0.5, 1, 2, 4, 8 and 16 microg/ml of either amoxicillin or doxycycline. The proportion of resistant bacteria was calculated based on the total number of colony-forming units present in the non-antibiotic containing plates. RESULTS On average, 0.4-13.4% and 0.9-20.4% of the total cultivable subgingival microbiota was resistant to the concentrations tested of amoxicillin and doxycycline, respectively. The differences between antibiotics were statistically significant for the 0.5, 2 and 4 mug/ml concentrations (p < 0.05, Wilcoxon's test). CONCLUSIONS Our findings revealed that a relatively small proportion of the total cultivable subgingival microbiota from Mexican subjects was resistant to amoxicillin and doxycycline.
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Affiliation(s)
- Argelia Almaguer-Flores
- Laboratory of Molecular Genetics, School of Dentistry, National University of Mexico (UNAM) Mexico city, Mexico
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Abstract
This position paper addresses the role of systemic antibiotics in the treatment of periodontal disease. Topical antibiotic therapy is not discussed here. The paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology. The document consists of three sections: 1) concept of antibiotic periodontal therapy; 2) efficacy of antibiotic periodontal therapy; and 3) practical aspects of antibiotic periodontal therapy. The conclusions drawn in this paper represent the position of the American Academy of Periodontology and are intended for the information of the dental profession.
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Pähkla ER, Koppel T, Saag M, Pähkla R. Metronidazole concentrations in plasma, saliva and periodontal pockets in patients with periodontitis. J Clin Periodontol 2005; 32:163-6. [PMID: 15691346 DOI: 10.1111/j.1600-051x.2005.00653.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Metronidazole is widely used antibacterial compound in the treatment of some types of periodontal disease. Pharmacokinetics of metronidazole in plasma has been well-described but few data exist about penetration of the drug to the gingival crevice fluid. The aim of the present study was to compare the concentrations of metronidazole in plasma, saliva and gingival crevice fluid in patients with periodontitis after multiple administration. MATERIALS AND METHODS Eleven patients with severe generalised adult periodontitis participated in the study. Metronidazole, 500 mg, was administered orally two or three times per day for at least 2 days before sample collection. Samples were collected 2 h after last dose. Metronidazole concentrations in all fluids were measured with high-performance liquid chromatography. RESULTS Mean drug concentrations in plasma, saliva and crevice fluid were 14.33, 15.15 and 12.86 microg/ml, respectively. Difference between plasma and crevice fluid or between plasma and saliva did not reach statistical significance. CONCLUSION Present study revealed that metronidazole penetrates well into gingival crevice fluid and saliva. Metronidazole concentrations in crevice fluid are about equal to the protein unbound drug concentrations in plasma. Therefore, general pharmacokinetic data of metronidazole can be also applied in the treatment of periodontal disease and in the design of respective treatment regimens.
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Affiliation(s)
- Ene-Renate Pähkla
- Department of Stomatology, University of Tartu, Ravila Str. 19, 51014 Tartu, Estonia
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Xu Y, Höfling K, Fimmers R, Frentzen M, Jervøe-Storm PM. Clinical and microbiological effects of topical subgingival application of hyaluronic acid gel adjunctive to scaling and root planing in the treatment of chronic periodontitis. J Periodontol 2004; 75:1114-8. [PMID: 15455740 DOI: 10.1902/jop.2004.75.8.1114] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Hyaluronic acid (HA) has shown anti-inflammatory effects in gingivitis therapy. The potential benefits of local subgingival application of HA adjunctive to scaling and root planing (SRP) were evaluated in this study. METHODS Twenty patients with chronic periodontitis were included in this split-mouth study. Sulcus fluid flow rate (SFFR) and sulcus bleeding index were monitored at baseline and after 1, 2, 3, 4, 5, 6, and 12 weeks; probing depth and clinical attachment level were monitored at baseline and 6 and 12 weeks. Subgingival plaque samples were also taken at these same three appointments to determine the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis, and Treponema denticola. All patients were treated with full-mouth scaling and root planing (SRP); in addition, an HA gel was administered subgingivally in the test sites every week for 6 weeks. RESULTS An improvement of all clinical variables was observed (P < 0.05) in both groups. Clinically, no difference between test and control sites could be found. No difference between test and control sites was seen in the tested microorganisms. CONCLUSIONS No clinical or microbiological improvement was achieved by the adjunctive use of HA gel compared to SRP alone. Only SFFR was affected by the use of HA in terms of a more rapid reduction of SFFR in the test sites.
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Affiliation(s)
- Yi Xu
- Department of Operative Dentistry and Periodontology, Dental School, Hua Xi Medical Center, Sichuan University, Chengdu, China
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Rodrigues RMJ, Gonçalves C, Souto R, Feres-Filho EJ, Uzeda M, Colombo APV. Antibiotic resistance profile of the subgingival microbiota following systemic or local tetracycline therapy. J Clin Periodontol 2004; 31:420-7. [PMID: 15142209 DOI: 10.1111/j.1600-051x.2004.00493.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Tetracyclines have been extensively used as adjunctives to conventional periodontal therapy. Emergence of resistant strains, however, has been reported. This study evaluated longitudinally the tetracycline resistance patterns of the subgingival microbiota of periodontitis subjects treated with systemic or local tetracycline therapy+scaling and root planing (SRP). METHODS Thirty chronic periodontitis patients were randomly assigned to three groups: SRP+500 mg of systemic tetracycline twice/day for 14 days; SRP alone and SRP+tetracycline fibers (Actsite) at four selected sites for 10 days. Subgingival plaque samples were obtained from four sites with probing pocket depths (PPD)> or =6 mm in each patient at baseline, 1 week, 3, 6 and 12 months post-therapy. Samples were dispersed and diluted in pre-reduced anaerobically sterilized Ringer's solution, plated on Trypticase Soy Agar (TSA)+5% blood with or without 4 microg/ml of tetracycline and incubated anaerobically for 10 days. The percentage of resistant microorganisms were determined and the isolates identified by DNA probes and the checkerboard method. Significance of differences among and within groups over time was sought using the Kruskal-Wallis and Friedman tests, respectively. RESULTS The percentage of resistant microorganisms increased significantly at 1 week in the tetracycline groups, but dropped to baseline levels over time. The SRP+Actsite group presented the lowest proportions of resistant species at 6 and 12 months. No significant changes were observed in the SRP group. The predominant tetracycline-resistant species included Streptococcus spp., Veillonela parvula, Peptostreptococcus micros, Prevotella intermedia, Gemella morbillorum and Actinobacillus actinomycetemcomitans (Aa). A high percentage of sites with resistant Aa, Porphyromonas gingivalis and Tanerella forsythensis was observed in all groups at baseline. However, T. forsythensis was not detected in any group and P. gingivalis was not present in the SRP+Actsite group at 1 year post-therapy. Aa was still frequently detected in all groups after therapy. However, the greatest reduction was observed in the SRP+Actsite group. CONCLUSION Local or systemically administered tetracycline results in transitory selection of subgingival species intrinsically resistant to this drug. Although the percentage of sites harboring periodontal pathogens resistant to tetracycline were quite elevated in this population, both therapies were effective in reducing their prevalence over time.
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Affiliation(s)
- Rosa Maria J Rodrigues
- Departamento de Clínica Odontológica (Periodontia), Universidade Federal do Rio de Janerio, Rio de Janeiro, Brazil
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Quirynen M, Teughels W, van Steenberghe D. Microbial shifts after subgingival debridement and formation of bacterial resistance when combined with local or systemic antimicrobials. Oral Dis 2003; 9 Suppl 1:30-7. [PMID: 12974528 DOI: 10.1034/j.1601-0825.9.s1.6.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Antibiotics have played a major role in the improvement of life expectancy in the last 50 years and have led many to believe that bacterial infections were about to vanish as a disease entity of any importance. Emerging problems resulting from a widespread use of antibiotics have modified the general perception of the capabilities of antimicrobial agents. Over the years, bacteria have become increasingly resistant to formerly potent antimicrobial agents, including some antiseptics. The use of antimicrobials may also disturb the delicate ecological equilibrium of the body, allowing the proliferation of resistant bacteria or non-bacterial micro-organisms. This shift may initiate new infections that are worse than the ones originally treated. No antimicrobial drug is absolutely non-toxic and the use of an agent carries accompanying risks. This paper discusses the development and occurrence of antimicrobial resistance in the subgingival flora towards antiseptics and local or systemic antibiotics and is focussed on the question: how can the outcome of periodontal therapy with/without antimicrobials be improved?
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Affiliation(s)
- M Quirynen
- Catholic University of Leuven, Faculty of Medicine, Research Group for Microbial Adhesion, Department of Periodontology, School of Dentistry, Oral Pathology & Maxillo-facial Surgery, Leuven, Belgium.
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Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2002; 11:529-44. [PMID: 12426939 DOI: 10.1002/pds.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Affiliation(s)
- Jørgen Slots
- Department of Periodontology, School of Dentistry, University of Southern California, Los Angeles, USA
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Affiliation(s)
- Jørgen Slots
- Department of Periodontology, School of Dentistry, University of Southern California, Los Angeles, USA
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Slots J, Jorgensen MG. Effective, safe, practical and affordable periodontal antimicrobial therapy: where are we going, and are we there yet? Periodontol 2000 2002; 28:298-312. [PMID: 12013347 DOI: 10.1034/j.1600-0757.2002.2801123.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Several important trends are noticeable in the management of periodontal disease. Searching for specific risk factors for periodontal disease permits therapy planning with the intention of doing less for low-risk patients and increasing the preventive and therapeutic modalities for high-risk patients. Also, significant progress in the area of chemotherapeutic development enables dentists to increase the number of periodontitis patients receiving nondisruptive antimicrobial therapy and decreases the need for surgical treatment. Use of anti-infective chemotherapeutic and antibiotic agents has become a specialized and increasingly effective means of preventing and treating destructive periodontal disease. Local care, including subgingival application of some type of antiseptics, is widely accepted. The use of systemic antibiotics is not routine and should be reserved for aggressive and refractory periodontal infections. In general, it is better to be thoroughly familiar with a limited number of drugs and treatment methods and use them properly than to try to master a plethora of antimicrobial therapies. Combating periodontal infections is best accomplished by combined mechanical and chemotherapeutic efforts of the dental professional and the patient. The trend during recent years has been to treat periodontal infections aggressively, employing short-course antimicrobial therapy using a battery of safe and affordable antimicrobial agents, each exhibiting high activity against various periodontal pathogens and administered in ways to concurrently affect pathogens residing in different oral ecological niches, followed by regular maintenance visits having a strong anti-infective emphasis. At the beginning of therapy, patients should be assigned self-help tasks having maximal antimicrobial effectiveness, with a focus on control of the subgingival periodontopathic microbiota. When patients see positive clinical results from their daily oral hygiene efforts, they are motivated to remain active participants in managing their periodontal condition. This article emphasizes anti-infective periodontal therapies that are effective and, when properly administered, are essentially nontoxic; are widely available around the world to dentists as well as to patients; and are acceptable to most patients in terms of methods of application, supporting oral hygiene efforts and financial costs. We believe that, with improved knowledge of the periodontopathic microbiota, with the availability of microbiological tests to identify periodontal pathogens and optimal therapy, with various safe and affordable yet effective antimicrobial agents and therapies and, eventually, with the development of one or more effective vaccines, the future looks very bright for patients at risk for or suffering from destructive periodontal disease.
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Affiliation(s)
- Jørgen Slots
- Department of Periodontology, School of Dentistry, University of Southern California, Los Angeles, USA
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