Pharmacology for Dentistry

324 Section 9/ Chemotherapy

cocci (coagulase-positive, coagulase-nega-
tive and penicillinase producing strains),
Streptococcus pyogenes, Streptococcus
pneumoniae, Moraxella catarrhalis, H.
influenzae including beta-lactamase produc-
ing strains, E. coli, P. mirabilis, Klebsiella sp.,
N. gonorrhoeae.

Cefaclor is well absorbed after oral
administration. The presence of food may
delay the absorption of cefaclor but the total
amount absorbed remains unchanged.
About 25 percent of the drug is protein
bound. Cefaclor is widely distributed in the
body. It is rapidly excreted by the kidneys,
up to 85% appears unchanged in the urine
within two hours.

It is indicated in:

• Pneumonia, acute bronchitis and acute
  exacerbation of chronic bronchitis.


• Otitis media, pharyngitis, tonsillitis
  and sinusitis.


• Urinary tract infections.


• Skin and soft tissue infections.
  Cefaclor is generally well tolerated.
  However the reported adverse effects in-
  clude mild gastrointestinal reactions (nau-
  sea, vomiting, abdominal cramps and di-
  arrhoea). Symptoms of pseudomembra-
  nous colitis may appear either during or
  after antibiotic treatment. The other side
  effects are allergic in nature viz. skin rash,
  itching, bronchospasm, hypotension,
  erythema multiforme, Steven-Johnson
  syndrome. Other side effects viz.
  haemolytic anaemia, hypoprothrombine-
  mia, seizures and thrombophlebitis have
  been rarely reported.

CEFTAZIDIME

It is a broad spectrum cephalosporin

having anti-pseudomonal activity. Used

in serious infections of respiratory tract,

ENT and soft tissue infection, septicae-

mia, meningitis, GI and biliary tract in-

fections.

CEFOXITIN

It is produced by an Actinomyces. Used

in the treatment of anaerobic and mixed

surgical infections and lung abscess.

THIRD GENERATION CEPHALOSPORINS

CEFOTAXIME

A broad spectrum cephalosporin,

effective against staphylococci, Haemophilus

influenzae, Salmonella, Shigella, Serratia,

Citrobacter, Neisseria and Proteus.

The drug is given by parenteral route

and is deacetylated in body to active

metabolite which acts synergistically with

parent drug.

Adverse effects include skin rash,

drug fever, anaphylaxis, nausea, vomiting,

diarrhoea, thrombocytopenia and leu-

copenia. Local reaction and pain at injec-

tion site, pseudomembranous colitis and

headache.

It is used in respiratory, genitourinary

infections including gonorrhoea, septicemia,

meningitis, endocarditis; surgical, abdomi-

nal, bone and joint infections; preoperative

prophylaxis in those at increased risk of in-

fection and CNS infections.