Antibiotics and Antiseptics hal 14Kulik et al. [48] evaluated the resistance profiles of A. (Actinobacillus) actinomycetemcomitans, P. gingivalis, and P. intermedia/P. nigrescens to detect possible changes in antibiotic resistance over the time period of 19912005 in Switzerland, a country with the lowest antibiotic consumption among European countries. No antibiotic resistance was detected in P. gingivalis, whereas a few isolates of P. intermedia were not susceptible to clindamycin (0.9%), phenoxymethylpenicillin (13.5%), or tetracycline (12.6%). Amoxicillin/clavu- lanic acid, tetracycline, and metronidazole were the most effective antibiotics against A. actinomycetemcomitans with 0%, 0.8%, and 20.8% nonsusceptible isolates, respectively. However, 88% of the A. actinomycetemcomitans isolates were nonsusceptible to phenoxymethylpenicillin and 88% to clindamycin. When strains isolated in the years 19911994 were compared with those isolated in the years 20012004, there was no statistically significant difference in the percentage of A. actinomycetemcomitans strains nonsusceptible to clindamycin, metronidazole, or phenoxymethylpenicillin, or in the percentage of P. intermedia strains nonsusceptible to phenoxymethylpenicillin or tetracycline (P > 0.4 each).

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

Hal. 80The use of antibiotics in periodontal therapy carries potential risks for the periodontium. Elevated levels of penicillin- and tetracycline-resistant bacteria on sub- gingival microflora were demonstrated in periodontitis patients.Penggunaan antibiotik pada terapi periodontal meningkatkan potensi pada jaringan periodonsium. Tetrasiklin resistensi terhadap bakteri subgingiva pada periodontitis.Another potential disadvantage to long-term tetracycline therapy was suggested to be the permanent discoloration of the dentition that may not be limited only to tooth development in the child, but can also affect the adult dentition. When given over long periods of time in adults, the tetracycline molecule is incorporated into the continuously forming secondary dentin. The chronic sun exposure of the incorporated tetracycline may cause the formation of a reddish-purple oxidation product, resulting in discoloration of the permanent teethKekurangan dari pemberian tetrasiklin jangka panjang dapat menimbulkan diskolorasi gigi. Ketika diberikan dalam jangka waktu yang lama, molekul tetrasiklin dapat membentuk dentin sekunder. Paparan sinar matahari

Hal. 81 In the case of bacteriostatic tetracyclines, they can suppress susceptible periodontal pathogens but are not able to completely eradicate some key sub- gingival organisms. The effectiveness of bacterio- static antibiotics strongly depends on the host defence system, which may be impaired in the peri- odontal pocket [207].

Hal. 82 dan 172: tentang tetrasiklinHal. 84: the effectiveness of the adjunctive use of the tetracyclines in periodon- tal diseasethe use of systemic tetracycline is more beneficial than conventional treatment in the management of adult periodontal disease.Several small-scale clinical trials, evaluating the efficacy of tetracycline as an adjunct to SRP in the treatment of adult periodonti- tis, failed to demonstrate statistically significant differ- ences compared to SRP alone. However, mean PPD and AL were slightly improved in the tetracycline group [219].