By Scully, Crispian
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Additional resources for Oral and Maxillofacial Diseases: An Illustrated Guide to Diagnosis and Management of Diseases of the Oral Mucosa, Gingivae, Teeth, Salivary Glands, Bones and Joints, Third Edition
Example text
Immunocompromised patient Page 49 Table 4 ANTIBACTERIALS Drug Comments* Route Dose PENICILLINS Most oral bacterial infections respond well to drainage±penicillin Oral phenoxymethyl penicillin is usually effective and cheap Amoxicillin is often used and is usually effective, but almost four times as expensive Amoxicillin Orally effective (absorption better than ampicillin) Oral, IM or Broadspectrum penicillin derivative IV Staphylococcus aureus often resistant Not resistant to penicillinase Contraindicated in penicillin hypersensitivity Rashes in infectious mononucleosis, cytomegalovirus infection, lymphoid leukaemia, allopurinol May cause diarrhoea 250–500 mg 8 hourly Augmentin (Coamoxiclav) Mixture of amoxicillin and potassium clavulanate Inhibits some penicillinases and therefore active against Staphylococcus aureus Inhibits some lactamases and is therefore active against some Gramnegative and penicillin resistant bacteria Contraindicated in penicillin hypersensitivity Beware of diarrhoea and hepatobiliary events Oral 125/250 mg 8 hourly Ampicillin Less oral absorption than amoxicillin, otherwise as for amoxicillin (There are many analogues but these have few, if any, advantages) Contraindicated in penicillin hypersensitivity Oral, IM or IV 250–500 mg 6 hourly Benzylpenicillin Not orally active Most effective penicillin where organism sensitive Not resistant to penicillinase Contraindicated in penicillin hypersensitivity Large doses may cause K+ to fall and Na+ to rise Oral or IM 300–600 mg 6 hourly Flucloxacillin Orally active penicillin derivative Effective against most, but not all, penicillinresistant staphylococci Contraindicated in penicillin hypersensitivity Oral or IM 250 mg 6hourly Phenoxymethyl penicillin (Penicillin V) Orally active Best taken on empty stomach Not resistant to penicillinase Contraindicated in penicillin hypersensitivity Oral 250–500 mg 6 hourly + + IM, intramuscular; IV, intravenous; K , potassium; Na , sodium.
Phenytoin), mucocutaneous lymph node syndrome (Kawasaki syndrome), sarcoidosis Midline of the neck Submental lymphadenopathy Thyroglossal cyst Ectopic thyroid Salivary glands Thyroid tumours or goitre ‘Plunging’ ranula Mumps Ludwig’s angina Tumours Dermoid cyst Sjögren’s syndrome Other skin lesions Sarcoidosis Sialadenitis Sialosis Page 19 Oral complaints frequently associated with psychogenic factors* *Organic causes should first be excluded. Reassurance Corticosteroids intralesionally. Extirpate pulp.
G. Other red lesions may be erythroplasia, Kaposi’s sarcoma or other lesions (see page 11). phenytoin), mucocutaneous lymph node syndrome (Kawasaki syndrome), sarcoidosis Midline of the neck Submental lymphadenopathy Thyroglossal cyst Ectopic thyroid Salivary glands Thyroid tumours or goitre ‘Plunging’ ranula Mumps Ludwig’s angina Tumours Dermoid cyst Sjögren’s syndrome Other skin lesions Sarcoidosis Sialadenitis Sialosis Page 19 Oral complaints frequently associated with psychogenic factors* *Organic causes should first be excluded.