12/3/2023 0 Comments Endo words in spanish![]() Antibiotic resistance is the ability of a microorganism to resist the effects of such drugs and is produced by genetic changes in bacteria that are highly exposed to the drug ( 18). The abusive use of antibiotics has triggered an immunity of the bacteria to some of them, producing the so-called antibiotic resistances ( 17). Since Alexander Fleming discovered penicillin in 1928 and Florey introduced it to the clinical practice in 1940, antibiotics have been increasingly abused in Dentistry ( 16). Systemic antibiotics should be prescribed at the correct frequency, dose and duration so that the minimal inhibitory concentration is surpassed and so that side effects and the selection of resistant bacteria are prevented ( 15). As part of general antibiotic stewardship, it is currently recommended to prescribe antibiotics for 3 days and review the patient further antibiotics should only be pre-scribed if indicated clinically ( 3, 12- 14). In patients with penicillin allergy, clindamycin (600 mg loading dose followed b圓00 mg every 6 h), clarithromycin (500 mg loading dose followed by 250 mg every 12 h) or azithromycin (loading dose of 500 mg followed by 250 mgonce a day) can be prescribed. If penicillin V is used and therapy is ineffective, the combination of penicillin V with metronidazole (loading dose 1000 mg followed by 500 mg every 6 h) or amoxicillin with clavulanic acid is recommended. Recommended loading doses are 1000 mg of penicillin V administered orally followed by 500 mg every 4–6 h or 1000 mg amoxicillin, with or without clavulanic acid, followed by 500 mg every 8 h. Beta-lactam antibiotics (penicillin V and amoxicillin) are recommended for the treatment of endodontic infections. In determinated clinical situations produced by endodontic infections, systemic antibiotic treatment in conjunction with endodontic therapy is indicated in. albicans the most frecuently, are also implicated in endodontic disease ( 11). Futhermore, archaea ( 9), viruses ( 10) and fungi, with C. Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria, and Fusobacteria are the most abundant phyla, regardless of the infection type. Enterococcus faecalis is frequently associated with treatment failure ( 5- 8). Prevotella, Fusobacterium, Porphyromonas, Parvimonas, and Streptococcus are commonly detected genera in both type of infections. Nowdays, a significantly greater microbial diversity has been demonstrated in both type of infections. The persistent/secondary endodontics infections are typically more complex mixed-species, where gram-negative bacteria are the most dominant. In primary endodontic infection, that occurs in root canals that have previously not been treated, is frecuently polymicrobial in nature with gramnegative and gram-positive bacteria, dominated by obligate anaerobes. Usually, bacterias are usually organized in biofilm communities and can colonize the main canal and also other areas in the root canal system ( 4). However, there are some pulpal or periapical conditions, as well as patients, where the administration of antibiotics is necessary, in addition to endodontic therapy ( 3).Įndodontic infections are polymicrobial, involving a combination of gram-positive, gram-negative, facultative anaerobes and strict anaerobic bacteria. Most of these inflammatory-infectious conditions have a short duration and easy resolution as long as they are diagnosed early and the etiology factor is treated or removed through root canal treatment. Pulp and periapical pathology is caused by bacteria and their virulence factors ( 2). ![]() The main objective of root canal treatment is to prevent or cure apical periodontitis ( 1).
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