Oral and Maxillofacial Diseases: An Illustrated Guide to by Scully, Crispian

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By Scully, Crispian

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Extra 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.

While every attempt has been made to include accurate data, the authors and publishers accept no liability for Tables 1 to 15. 5 mg by injection; 5–10 mg orally *Opioids; NSAID, non­steroidal anti­inflammatory drug; IM, intramuscular; IV, intravenous; SC, subcutaneous; MAOI, monoamine oxidase inhibitor. g. herpes labialis 1% penciclovir or 5% aciclovir cream Consider systemic aciclovirb as above depending on risk to patient of infection – As above Consider oral acyclovira 800 mg, five times daily Herpes varicella­ Chickenpox zoster Zoster (shingles) a Otherwise healthy patient a,b In neonate, treat as if immunocompromised.

Exclude Sjögren’s syndrome Consider duct dilatation.  While every attempt has been made to include accurate data, the authors and publishers accept no liability for Tables 1 to 15. 5 mg by injection; 5–10 mg orally *Opioids; NSAID, non­steroidal anti­inflammatory drug; IM, intramuscular; IV, intravenous; SC, subcutaneous; MAOI, monoamine oxidase inhibitor. g. herpes labialis 1% penciclovir or 5% aciclovir cream Consider systemic aciclovirb as above depending on risk to patient of infection – As above Consider oral acyclovira 800 mg, five times daily Herpes varicella­ Chickenpox zoster Zoster (shingles) a Otherwise healthy patient a,b In neonate, treat as if immunocompromised.

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