Use: Treat aerobic gram positive cocci and anaerobic infections. Including dental, respiratory tract, otitis media, sinusitis, and urinary tract.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Candidiasis, glossitis, stomatitis, black hairy tongue, dry mouth, altered taste and blood dyscrasias.
Medical Considerations: >10%; nausea, vomiting, diarrhea
1-10%; hypersensitivity reactions
Penicillin Derivative (continued)
Medical Considerations: Other adverse reactions; coma, depression, convulsions, lethargy, hallucinations, anxiety, twitching, abdominal pain, colitis, anorexia, oliguria, proteinuria, hematuria, vaginitis, monoliasis, glomerulonephritis, hyperkalemia, hypokalemia and alkalosis.
Precautions: Severe renal impairment, seizure history and allergic to cephalosporins. Can reduce effectiveness of oral contraceptives. Pregnancy category B, lactation ok.
Dental Drug Interactions: When used with tetracyclines, erythromycin and lincomycin there is a decreased effectiveness. Acts synergistically with aminoglycosides. Probenecid increases blood levels of penicillins.
Penicillin V Potassium (Pen Vee K, V-Cillin K, Veetids)
First choice for common orofacial infections. Not for endocarditis or orthopedic prosthesis prophylaxis.
Amoxicillin (Amoxil, Biomox, Trimox)
First choice for endocarditis, prosthesis prophylaxis. Superinfections tend to develop rash with infectious mononucleosis.
Ampicillin (Amcill, Polycillin)
Alternative for dental prophylaxis. Severe abdominal cramps. Increases effect of oral anticoagulants.Can develop nonallergic rash, especially if viral and Salmonella infections, lymphocytic leukemia, hyperuricemia or taking Allopurinol.
Penicillin Derivative +
Amoxicillin and Clavulanate Potassium (Augmentin)
Clavulanate inactivates beta lactamase, can use with beta-lactamase staphylococci and bacteroides. Rash with Allopurinol. Treat otitis media, sinusitis, lower respiratory
tract, urinary tract, skin infections and gonorrhea. Increased diarrhea. Caution if hepatic dysfunction.
Ampicillin and Sulbactam (Unasyn)
Sulbactam is a beta-lactamase inhibitor. Treat severe orofacial infections from Staphylococci and Bacteroides.
Treat skin, intrabdominal and gynecological infections. Only given I.M. or I.V. May follow with oral Augmentin.
Good against beta-lactamase producers S. aureus, H. influenzae, E. coli, Klebsiella, Acinetobacter, Enterobacter and anaerobes.
Action: Inhibits RNA dependent protein synthesis by binding 50S ribosomal subunit.
Use: Alternative to penicillin for orofacial infections. Also treat M. pneumoniae, Legionella pneumophilia, diphtheria, pertussis, chancroid, Chlamydia and Campylobacter gastroenteritis.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Candidiasis and tinnitus. Pregnancy category B, lactation ok.
Medical Considerations: >10%; abdominal pain, cramping, nausea and vomiting.
1-10%; cholestatic jaundice and hypersensitivity reactions.
Medical Considerations: Other adverse reactions; heartburn, pruritis ani, psuedomembranous colitis, vaginitis, monoliasis and hearing loss.
Contraindications: Hepatic disease.
Dental Drug Interactions: Decreases action of clindamycin, penicillins, lincomycin and oral contraceptives. Increases effects of oral anticoagulants and benzodiazepines.
Medical Drug Interactions: Increases effects of alfentanil, carbamazepine, theophylline, felodipine, triazolam and ergotamine. Contraindicated with pimozole, terfenadine, astemizole, lovastin and cisapride.