Antibiotics and Antiseptics hal 14

Kulik et al. [48] evaluated the resistance profiles of A. (Actinobacillus)

actinomycetemcomitans, P. gingivalis, and P. intermedia/P. nigrescens to detect
possible changes in antibiotic resistance over the time period of 19912005 in
Switzerland, a country with the lowest antibiotic consumption among European
countries. No antibiotic resistance was detected in P. gingivalis, whereas a few
isolates of P. intermedia were not susceptible to clindamycin (0.9%),
phenoxymethylpenicillin (13.5%), or tetracycline (12.6%). Amoxicillin/clavulanic acid, tetracycline, and metronidazole were the most effective antibiotics
against A. actinomycetemcomitans with 0%, 0.8%, and 20.8% nonsusceptible
isolates, respectively. However, 88% of the A. actinomycetemcomitans isolates
were nonsusceptible to phenoxymethylpenicillin and 88% to clindamycin. When
strains isolated in the years 19911994 were compared with those isolated in the
years 20012004, there was no statistically significant difference in the percentage
of

A.

actinomycetemcomitans

strains

nonsusceptible

to

clindamycin,

metronidazole, or phenoxymethylpenicillin, or in the percentage of P. intermedia

strains nonsusceptible to phenoxymethylpenicillin or tetracycline (P > 0.4 each).

The tetracyclines, metronidazole, and b-lactams are among the most widely used
agents for treating periodontal conditions. Mechanisms of bacterial resistance to
these antibiotics have been extensively described and attributed to resistance genes
[44]. Many genes for bacterial resistance to tetracycline have been identified and
characterized.
Tetrasiklin, metronidazole, dan b-lactam adalah obat yang paling sering digunakan
untuk terapi periodontal. Mekanisme resistensi bakteri terhadap tetrasiklin telah
diidentifikasi.

Hal. 80

Theuseofantibioticsinperiodontaltherapycarriespotentialrisksforthe
periodontium.Elevatedlevelsofpenicillinandtetracyclineresistantbacteriaon
subgingivalmicrofloraweredemonstratedinperiodontitispatients.
Penggunaanantibiotikpadaterapiperiodontalmeningkatkanpotensipadajaringan
periodonsium.Tetrasiklinresistensiterhadapbakterisubgingivapada
periodontitis.
Anotherpotentialdisadvantagetolongtermtetracyclinetherapywassuggestedto
bethepermanentdiscolorationofthedentitionthatmaynotbelimitedonlyto
toothdevelopmentinthechild,butcanalsoaffecttheadultdentition.Whengiven
overlongperiodsoftimeinadults,thetetracyclinemoleculeisincorporatedinto
thecontinuouslyformingsecondarydentin.Thechronicsunexposureofthe
incorporatedtetracyclinemaycausetheformationofareddishpurpleoxidation
product,resultingindiscolorationofthepermanentteeth
Kekurangandaripemberiantetrasiklinjangkapanjangdapatmenimbulkan
diskolorasigigi.Ketikadiberikandalamjangkawaktuyanglama,molekul
tetrasiklindapatmembentukdentinsekunder.Paparansinarmatahari

Hal.81

Inthecaseofbacteriostatictetracyclines,theycansuppresssusceptible
periodontalpathogensbutarenotabletocompletelyeradicatesomekeysub
gingivalorganisms.Theeffectivenessofbacteriostaticantibioticsstrongly
dependsonthehostdefencesystem,whichmaybeimpairedintheperiodontal
pocket[207].

Hal.82dan172:tentangtetrasiklin
Hal.84:theeffectivenessoftheadjunctiveuseofthetetracyclinesinperiodon

taldisease

theuseofsystemictetracyclineismorebeneficialthanconventionaltreatmentin
themanagementofadultperiodontaldisease.

Severalsmallscaleclinicaltrials,evaluatingtheefficacyoftetracyclineasan
adjuncttoSRPinthetreatmentofadultperiodontitis,failedtodemonstrate
statisticallysignificantdifferencescomparedtoSRPalone.However,meanPPD
andALwereslightlyimprovedinthetetracyclinegroup[219].