Dento-alveolar Infections2... · Ƀlactum antibiotics Combinations of amoxicillin with clavuonic...

49
Dento-alveolar Infections Ass. Prof. Dr/ Hamed Gad

Transcript of Dento-alveolar Infections2... · Ƀlactum antibiotics Combinations of amoxicillin with clavuonic...

Dento-alveolar

Infections

Ass Prof Dr Hamed Gad

USE OF BACTERICIDAL

RATHER THAN

BACTERIOSTATIC ANTIBIOTIC

Advantages of bactericidal antibiotics are

1 Less reliance on host resistance

2 Killing of bacteria by antibiotic itself

3 Greater flexibility with dosage intervals

4 Faster results than bacteriostatic

BACTERICIDAL

ANTIBIOTICS

BACTERIOSTA

TIC

ANTIBIOTICS

Penicillins Tetracyclines

Cephalosporins Arithromycin

Aminoglycosides Clarithromycin

Vancomycin Azithromycin

Fluoroquinolones Clindamycin

Metronidazole Sulfa

Ƀ lactum antibiotics

Penicillin

it is considered an antibiotic of choice for the treatment of

odontogenic infections

Penicillin inhibits synthesis of the cell wall

The semisynthetic derivatives(amoxicillin- ampicillen) is

effective against

aerobic Gram-positive rods

Gram negative amp Gram-positive cocci

combinations of semisynthetic penicillins

with various 1048642 -lactamase inhibitors

1Ampicillin with sulbactam

2 Amoxicillin with clavulanic acid

Ƀ lactum antibiotics

Ƀ lactum antibiotics

Combinations of ampicillin with sulbactam

Sulbin 375 Vial 400

750 650

1500 925

Unictam 375 Tab 30

250 Susp 21

375 Vial 375

750 600

1500 Vial 11

Unasyne 375 Tab 40

250 Susp 33

375 Vial 800

750 1200

1500 1700

3000 Vial 2400

Others ampictam sigmacyn ultracillin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

USE OF BACTERICIDAL

RATHER THAN

BACTERIOSTATIC ANTIBIOTIC

Advantages of bactericidal antibiotics are

1 Less reliance on host resistance

2 Killing of bacteria by antibiotic itself

3 Greater flexibility with dosage intervals

4 Faster results than bacteriostatic

BACTERICIDAL

ANTIBIOTICS

BACTERIOSTA

TIC

ANTIBIOTICS

Penicillins Tetracyclines

Cephalosporins Arithromycin

Aminoglycosides Clarithromycin

Vancomycin Azithromycin

Fluoroquinolones Clindamycin

Metronidazole Sulfa

Ƀ lactum antibiotics

Penicillin

it is considered an antibiotic of choice for the treatment of

odontogenic infections

Penicillin inhibits synthesis of the cell wall

The semisynthetic derivatives(amoxicillin- ampicillen) is

effective against

aerobic Gram-positive rods

Gram negative amp Gram-positive cocci

combinations of semisynthetic penicillins

with various 1048642 -lactamase inhibitors

1Ampicillin with sulbactam

2 Amoxicillin with clavulanic acid

Ƀ lactum antibiotics

Ƀ lactum antibiotics

Combinations of ampicillin with sulbactam

Sulbin 375 Vial 400

750 650

1500 925

Unictam 375 Tab 30

250 Susp 21

375 Vial 375

750 600

1500 Vial 11

Unasyne 375 Tab 40

250 Susp 33

375 Vial 800

750 1200

1500 1700

3000 Vial 2400

Others ampictam sigmacyn ultracillin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

BACTERICIDAL

ANTIBIOTICS

BACTERIOSTA

TIC

ANTIBIOTICS

Penicillins Tetracyclines

Cephalosporins Arithromycin

Aminoglycosides Clarithromycin

Vancomycin Azithromycin

Fluoroquinolones Clindamycin

Metronidazole Sulfa

Ƀ lactum antibiotics

Penicillin

it is considered an antibiotic of choice for the treatment of

odontogenic infections

Penicillin inhibits synthesis of the cell wall

The semisynthetic derivatives(amoxicillin- ampicillen) is

effective against

aerobic Gram-positive rods

Gram negative amp Gram-positive cocci

combinations of semisynthetic penicillins

with various 1048642 -lactamase inhibitors

1Ampicillin with sulbactam

2 Amoxicillin with clavulanic acid

Ƀ lactum antibiotics

Ƀ lactum antibiotics

Combinations of ampicillin with sulbactam

Sulbin 375 Vial 400

750 650

1500 925

Unictam 375 Tab 30

250 Susp 21

375 Vial 375

750 600

1500 Vial 11

Unasyne 375 Tab 40

250 Susp 33

375 Vial 800

750 1200

1500 1700

3000 Vial 2400

Others ampictam sigmacyn ultracillin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

Penicillin

it is considered an antibiotic of choice for the treatment of

odontogenic infections

Penicillin inhibits synthesis of the cell wall

The semisynthetic derivatives(amoxicillin- ampicillen) is

effective against

aerobic Gram-positive rods

Gram negative amp Gram-positive cocci

combinations of semisynthetic penicillins

with various 1048642 -lactamase inhibitors

1Ampicillin with sulbactam

2 Amoxicillin with clavulanic acid

Ƀ lactum antibiotics

Ƀ lactum antibiotics

Combinations of ampicillin with sulbactam

Sulbin 375 Vial 400

750 650

1500 925

Unictam 375 Tab 30

250 Susp 21

375 Vial 375

750 600

1500 Vial 11

Unasyne 375 Tab 40

250 Susp 33

375 Vial 800

750 1200

1500 1700

3000 Vial 2400

Others ampictam sigmacyn ultracillin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

combinations of semisynthetic penicillins

with various 1048642 -lactamase inhibitors

1Ampicillin with sulbactam

2 Amoxicillin with clavulanic acid

Ƀ lactum antibiotics

Ƀ lactum antibiotics

Combinations of ampicillin with sulbactam

Sulbin 375 Vial 400

750 650

1500 925

Unictam 375 Tab 30

250 Susp 21

375 Vial 375

750 600

1500 Vial 11

Unasyne 375 Tab 40

250 Susp 33

375 Vial 800

750 1200

1500 1700

3000 Vial 2400

Others ampictam sigmacyn ultracillin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

Ƀ lactum antibiotics

Combinations of ampicillin with sulbactam

Sulbin 375 Vial 400

750 650

1500 925

Unictam 375 Tab 30

250 Susp 21

375 Vial 375

750 600

1500 Vial 11

Unasyne 375 Tab 40

250 Susp 33

375 Vial 800

750 1200

1500 1700

3000 Vial 2400

Others ampictam sigmacyn ultracillin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

Combinations of ampicillin with sulbactam

Sulbin 375 Vial 400

750 650

1500 925

Unictam 375 Tab 30

250 Susp 21

375 Vial 375

750 600

1500 Vial 11

Unasyne 375 Tab 40

250 Susp 33

375 Vial 800

750 1200

1500 1700

3000 Vial 2400

Others ampictam sigmacyn ultracillin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Combinations of amoxicillin with clavuonic acid

Hi-biotic 375 10 tab 2200 amoun

625 10 tab 2600

1 gm 7 tab 2500

312 Susp 1500

460 Susp 2300

E-moxclav 375 Tab 2600 epico

625 3000

1 gm Tab 3300

312 Susp 1800

625 Susp 2400

Deltaclav 457 Susp 1800

Curam 625 Tab 1200

1 gm 1500

312 Susp 2100

Augmentin 375 Tab 3000

625 3500

1gm 5800

457 Susp 3700

600 Vial 115

1200 Vial 2000

Megamox 1gm Tab 50

625 Tab 40

228 Susp 2300

457 Susp 3500

Magnabiotic 625 Tab 200

312 Susp 180

600 Vial 90

1200 Vial 1600

Julmentin

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Cephalosporins

The mechanism of action of cephalosporins regardless of

generation is the same as that of penicillin

Cephalosporins are considered relatively safe drugs during

pregnancy (category B according to FDA categorization) and

their dose needs to be decreased only in case of advanced

renal failure

Ƀ lactum antibiotics

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Antimicrobial spectrum of cephalosporins

Generation of cephalosporins

Active towards

Gram-positive bacteria(cocci amp rods)

(aerobic ampanaerobic)

Gram-negative bacteria

(cocci amp rods) aerobic )

І +++ +-

ІІ

++ +

ІІІ

+ +++

ІV ++ +++

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

First generation

Similar to penicillinase-resistant

penicillins with greater gram-

negative coverage

Used for

community-acquired infections

mild to moderate infections

Not penetrate CNS

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

First generation

1- cephalexin

2- cefadroxil

3- cephradine

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Ƀ lactum antibiotics

First generation

1- cephalexin

ceporex

tab 500

1gm

vial 500

1gm

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

First generation

2- cefadroxil

Curicef 500 Cap

1gm Cap

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

First generation

2- cefadroxil

Duricef 500 Cap

1gm tab

500 Susp

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

3- cephradine

Velocif 500 Cap

1gm Cap

500 Vial

1 gm Vial

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Third generation HIGLY Active toward aerobic gr ndashve

rods

1-Cefotaxime

2- cefoperazne sodium

3- ceftriaxone

ceftazidime (Fortum)

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Cefotax 500 Vial

1gm

Foxime 500

1 gm

Xorin 500

1gm Vial

1-Cefotaxime

Third generation

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Third generation

2- cefoperazne sodium

Cefazone 500 Vial

1gm Vial

Cefobid 500 Vial

1gm Vial

Cefoctam 1500 Vial

Peractam

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

bull

Third Generation 3- ceftriaxone

IV and IM long half-life once-a-day dosing

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Third Generation 4- ceftazidime (Fortum) fortum vial 500 amp 1 gm

IV and IM

Excellent gram-negative coverage

Used for difficult-to-treat organisms such as Pseudomonas spp

Eliminated renally instead of biliary route

Excellent spectrum of coverage

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Macrolides

Their antimicrobial spectrum includes

Gram-positive aerobic and anaerobic

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

- Macrolides

Clindamycin HCL

Clindam 150 Tab

300

Clindacyn 150

300

Clindacin 150

Dalacin c 150

300 Tab

600 Vial

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Macrolides

Zithrocin 500 Cap

Zithrokan 500 Cap

Zithromax 500 Cap

600 Susp

900

500 Vial

Athizthromycin

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Metronidazole They are drugs with rapid bactericidal action

principally against

Gram-negative and +ve anaerobes

The usual dose for oral administration is 500 mg

every 8 h

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Penicillin Is effective against aerobic gram-positive

rods amp Gram negative amp Gram-positive cocci

1st

generation Similar to penicillinase-resistant penicillins

with greater gram-negative coverage

Third generation HIGLY active toward aerobic gr ndashve rods

Macrolides

Their antimicrobial spectrum includes gram-

positive aerobic and anaerobic

Metronidazole Gram-negative and +ve anaerobes

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Home massage for antibiotic

therapy Removal of the cause drainage and

supportive care more important than

antibiotic therapy

Infections are cured by the patientrsquos

defenses not antibiotics

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

What is the antibiotic of choice for

treatment of odontogenic infection

1 penicillin or cephalosporine plus metronidazole

2 clindamycin is an excellent alternative plus

metronidazole

3 Erythromycin

---------------------------------------------------

1 Definitive antibiotic therapy should be based on

culture and sensitivity

2 Antibiotics should be prescribed for at least one

week

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

III

H- EVALUATE THE PATIENT

FREQUENTLY

1 Subjective sense of feeling better

2 Objective signs of improvement

3 Review culture amp sensitivity reports

4 Re-evaluate host responses if

necessary

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Lower premolars

Sublingual space Submandibular

space Lateral pharyngeal

space Retropharyngeal space

Superior mediastinum

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Complications of odontogenic

infections

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Orbital cellulitis and blindness

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

- Ludwigs angina

Ludwigs angina is bilateral

brawny induration of the

submandibular sublingual

and submental spaces

The term angina is used because

of the respiratory distress

caused by the airway

obstruction

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

The incisions must be bilateral

extraoral parallel and

medial to the inferior border

of the mandible at the

premolar and molar region

and intraoral parallel to the

ducts of the submandibular

glands

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

It is an uncommon but potentially

lethal extension of odontogenic

infection

An orofacial infection can reach the

cavernous sinus through two

routes

1 an anterior route via the angular

and inferior ophthalmic veins and

2 posterior route via the transverse

facial vein and the pterygoid

plexus of veins

- Cavernous sinus thrombosis

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Cavernous sinus thrombosis

The first clinical signs of cavernous sinus

thrombosis include vascular congestion in

periorbital scleral and retinal veins

Other clinical signs include periorbital edema

proptosis thrombosis of the retinal vein dilated

pupils absent corneal reflex and supraorbital

sensory deficits

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

3- Cervicofacial

necrotizing fasciitis

Cervicofacial necrotizing fasciitis is a

very aggressive infection of the skin and

superficial fascia of the head and neck

and is commonly seen in diabetic and

immunocompromised patients

It carries a mortality rate of 30-50

from sepsis of the dead tissue in the

affected area

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

Necrotizing fasciitis Large granulating skin defect extending from the inferior border of the mandible to the clavicle 2 weeks After deacutebridement

4- pulmonary

abscess

THANK YOU

THANK YOU

4- pulmonary

abscess

THANK YOU

THANK YOU

THANK YOU

THANK YOU