Pharmacology for Dentistry

332 Section 9/ Chemotherapy

Mycoplasma, Campylobacter, Legionella,
Gardnerella vaginalis are also highly
sensitive.

Adverse effects include gastrointesti-
nal side effects like nausea, epigastric pain
are common. Diarrhoea occurs occasion-
ally. Skin rashes, hypersensitivity reaction,
hepatotoxicity (hepatitis alongwith
cholestatic jaundice, especially with
estolate ester), oral candidiasis, throm-
bophlebitis and fever have been reported.

Erythromycin is used as a substitute to
penicillin in allergic patients for upper
respiratory tract infections, e.g. tonsillitis,
pharyngitis and mastoiditis, pneumococcal
infection and prophylaxis of rheumatic
fever. It is drug of choice in treatment of
atypical pneumonia due to Mycoplasma
pneumoniae, Legionnaire’s pneumonia and
whooping cough. It is also useful in wound
and burn infections and severe impetigo not
responding to topical antibiotics.

ROXITHROMYCIN

Roxithromycin is a semisynthetic
macrolide antibiotic.

It is effective against Streptococcus
pyogenes, Streptococcus viridans, Streptococcus
pneumoniae, Staphylococcus mitis, S. aureus and
coagulase negative staphylococci, Neisseria
meningitidis, Bordetella pertussis, Moraxella
catarrhalis, Corynebacterium diphtheriae, List-
eria monocytogenes, Clostridium, Mycoplasma
pneumoniae, Pasteurella multocida, Chlamydia
trachomatis/psittaci/pneumoniae, Ureaplasma
urealyticum, Legionella pneumophila,
Helicobacter pylori, Gardnerella vaginalis.

It is more stable in acid media than
other macrolides. Roxithromycin is found

in the serum after 15 minutes of

administration. It is more than 90% plasma

protein bound and more than half the dose

is excreted unchanged in urine and faeces.

Adverse effects include gastrointesti-

nal symptoms like nausea, vomiting, epi-

gastric pain, diarrhoea, hypersensitivity

reactions like rash, urticaria, angioedema,

exceptionally bronchospasm, anaphylactic

shock; dizzy sensations (caution in driving

or use of machinery); moderate increase in

ASAT, ALAT and/or alkaline phos-

phatases; cholestatic or more rarely acute

liver injury.

AZITHROMYCIN

Azithromycin is an azalide antibiotic,

a sub-class of the macrolides. Azithromycin

differs chemically from erythromycin in

that a methyl substituted nitrogen atom is

incorporated into the lactone ring.

Following oral administration,

azithromycin is rapidly absorbed and

widely distributed throughout the body.

Rapid distribution into tissues and high

concentration within cells result in signifi-

cantly higher azithromycin concentration

is tissues than in plasma or serum.

Azithromycin is indicated for the

treatment of following infections caused by

sensitive organisms:

1. Lower respiratory tract infections:
   Community-acquired pneumonia,
   acute bacterial exacerbations of
   chronic obstructive pulmonary
   disease, acute bronchitis due to
   Haemophilus influenzae, Moraxella
   catarrhalis or Streptococcus pneumoniae.


2. Ear, nose and throat infections like
   tonsillitis, sinusitis, otitis media and
   pharyngitis.