tetracycline and Actinobacillus-Infections

Both systemic and topical antibiotics are increasingly used in the management of periodontal infections. Whilst these drugs are used mostly on an empirical basis, some contend that rational use of antibiotics should be the norm due to their wide abuse and consequential global emergence of antibiotic resistance organisms. Here we review the rationale and principles of antimicrobial therapy, treatment goals, drug delivery routes and various antibiotics that are used in the management of periodontal diseases. The pros and cons of systemic and local antibiotic therapy are described together with practical guidelines for their delivery. The available data indicate, in general, that mechanical periodontal treatment alone is adequate to ameliorate or resolve the clinical condition in most cases, but adjunctive antimicrobial agents, delivered either locally or systemically, can enhance the effect of therapy in specific situations. This is particularly true for aggressive (early onset) periodontitis, in patients with generalised systemic disease that may affect host resistance and in case of poor response to conventional mechanical therapy. Locally delivered antibiotics together with mechanical debridement are indicated for non-responding sites of focal infection or in localised recurrent disease. After resolution of the periodontal infection, the patient should be placed on an individually tailored maintenance care programme. Optimal plaque control by the patient is of paramount importance for a favourable clinical and microbiological response to any form of periodontal therapy.

Topics: Actinobacillus Infections; Administration, Oral; Administration, Topical; Aggregatibacter actinomycetemcomitans; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bacteroidaceae Infections; Chlorhexidine; Humans; Metronidazole; Periodontitis; Porphyromonas gingivalis; Tetracycline

The current study assessed the clinical and microbiological effects of systemic antimicrobial therapy alone in Actinobacillus actinomycetemcomitans-infected adolescents with periodontal disease. The study involved 6 localized juvenile periodontitis patients 13-18 years of age, who harbored high numbers of A. actinomycetemcomitans in subgingival plaque samples. The periodontal lesions were microbiologically monitored by selective culture, and clinically assessed for probing pocket depth and periodontal attachment level 3 months prior to baseline, and at 3, 6, 12, and 24 months posttreatment. Tetracycline-HCl (250 mg/QID) was prescribed until 1 week after subgingival A. actinomycetemcomitans was no longer detectable or for a maximum of 8 weeks. During 3 months prior to treatment, pocket depth was unchanged, and was then significantly reduced from an average of 7.1 mm to 5.1 mm 12 months after treatment (p = 0.02). The mean change in clinical attachment level was a gain of 1.4 mm between baseline and 12 months (p = 0.02). 3 of the 6 patients were still infected with A. actinomycetemcomitans after 8 weeks of antibiotic therapy and 4 subjects were infected at 12 months. Numbers of A. actinomycetemcomitans were still suppressed in most lesions. There was a strong association between mean numbers of A. actinomycetemcomitans in periodontal pockets and mean change in probing attachment level at any given time point. For 22 available comparisons, derived from all time points, there was a strong association (r = 0.68) between subgingival A. actinomycetemcomitans and change in probing attachment level.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Actinobacillus Infections; Adolescent; Aggregatibacter actinomycetemcomitans; Aggressive Periodontitis; Chi-Square Distribution; Colony Count, Microbial; Female; Humans; Male; Periodontal Index; Periodontal Pocket; Tetracycline

Four groups of six specific pathogen-free (SPF) pigs were inoculated intranasally with Actinobacillus pleuropneumoniae serotype 2 and treated with either enrofloxacin, tetracycline or penicillin at the onset of clinical disease, or left untreated. A fifth group was left uninoculated. The inoculated control and the penicillin-treated groups developed severe disease, but the groups treated with enrofloxacin and tetracycline recovered rapidly. All the inoculated pigs, except those treated with enrofloxacin developed serum antibodies to A pleuropneumoniae. On day 28, all five groups were challenged with A pleuropneumoniae without any subsequent treatment. The previously uninoculated control group and the enrofloxacin-treated group developed severe disease, but the three seropositive groups remained unaffected.

Topics: Actinobacillus Infections; Actinobacillus pleuropneumoniae; Animals; Anti-Bacterial Agents; Antibodies, Bacterial; Disease Models, Animal; Enrofloxacin; Euthanasia, Animal; Fluoroquinolones; Penicillins; Respiratory Tract Diseases; Specific Pathogen-Free Organisms; Swine; Swine Diseases; Tetracycline

A total of 101 Actinobacillus pleuropneumoniae isolates from diseased pigs taken from across Japan during 2002 to 2005 were examined for antimicrobial susceptibility. All isolates were susceptible to ceftiofur, erythromycin, florfenicol and enrofloxacin. Antimicrobial-resistant isolates to oxytetracycline (OTC) (27.7%), dihydrostreptomycin (10.9%), thiamphenicol (10.9%), kanamycin (5.9%), trimethoprim (4.0%) and ampicillin (2.0%) were recognized. OTC-resistant isolates taken from 1986 to 2005 were examined for the tetracycline resistance gene. In OTC-resistant isolates, tetB has been the most frequently isolated gene in Japan. It is likely that the dissemination of tetB has contributed to the increased OTC resistance of A. pleuropneumoniae in Japan.

Topics: Actinobacillus Infections; Actinobacillus pleuropneumoniae; Animals; Anti-Bacterial Agents; Japan; Microbial Sensitivity Tests; Swine; Swine Diseases; Tetracycline; Tetracycline Resistance

Two different PCR-based molecular approaches, a commercial kit for detection of A. actinomycetemcomitans, P. gingivalis, P. intermedia, B. forsythus and T. denticola (Amplimedical "Paradonthosis") and a home-made multiplex PCR for A. actinomycetemcomitans, P. gingivalis and B. forsythus were compared for monitoring the efficacy of different dental treatments on localized persistent periodontal pockets. 44 sites were randomized in two treatment groups: mechanical treatment (22 control sites) and in conjunction with the application of tetracycline fibres (22 experimental sites). 40/44 sites were found positive with both tests for A. actinomycetemcomitans, P. gingivalis and B. forsythus pretheraphy. P. intermedia was detected alone in only three sites during the follow-up, while T. denticola. was always associated with the other pathogens. 20 sites were positive in conventional cultures for one to three of the pathogens. PCR-based approaches provided a sensitive and reliable method for identification and monitoring treatment of periodontal pathogens.

Topics: Actinobacillus Infections; Aggregatibacter actinomycetemcomitans; Bacteroides; Bacteroides Infections; DNA, Bacterial; Humans; Middle Aged; Periodontitis; Polymerase Chain Reaction; Pseudomonas; Pseudomonas Infections; Tetracycline

An autogenous, multivalent, adjuvanted bacterin for epididymitis was tested in flocks of 700 to 800 Suffolk X white-faced lambs. Long-term feeding of low dosages of antibiotics also was tested in the Suffolk flock. Both methods appeared to reduce the incidence of the disease. The incidence of clinical epididymitis and the number of positive culture results from clinically affected rams were significantly reduced.

Topics: Actinobacillus; Actinobacillus Infections; Animals; Bacterial Vaccines; Epididymitis; Haemophilus; Haemophilus Infections; Male; Sheep; Sheep Diseases; Sulfamethazine; Tetracycline; Time Factors

The bacterium Actinobacillus actinomycetemcomitans is found in large numbers in subgingival plaque and gingival tissues of patients with LJP and PLS. This bacterium too has been found to cause infective bacterial endocarditis in patients at risk. Antibiotic prophylaxis is necessary for at risk patients with LJP and PLS because significant bacteraemia is produced during extensive periodontal instrumentation, extractions and surgery which are required in managing these cases. The current antibiotic regimens recommended by the American Heart Association/Council on Dental Therapeutics are not effective against this bacterium. A two-stage prophylactic approach is advocated, first with tetracycline for two weeks to eliminate the Actinobacillus actinomycetemcomitans, followed by the regimens recommended by the American Heart Association on the day of the dental procedure itself. Tetracycline should not be used concurrently or as a substitute for the recommended regimens by the American Heart Association/Council on Dental Therapeutics.

Topics: Actinobacillus Infections; Aggressive Periodontitis; Endocarditis, Bacterial; Humans; Keratoderma, Palmoplantar; Papillon-Lefevre Disease; Periodontal Diseases; Tetracycline

WITH THE MORE FREQUENT USE of antibiotics as adjuncts to periodontal therapy today, it is imperative that dental clinicians be aware of adverse reactions to these drugs, regardless of their reported incidence. It is the purpose of this case report to present and describe a rare adverse reaction to tetracycline hydrochloride called pseudotumor cerebri or benign intracranial hypertension. It is manifested by an abnormal increase in intracranial pressure and papilledema in a patient with an otherwise normal neuroradiologic condition. Although severe headache appears to be the most bothersome acute symptom, the more important long-term side effect is visual loss caused by the papilledema. Treatment should be directed towards discontinuation of the drug therapy, and immediate referral to a physician for a neuro-ophthalmic evaluation.

Topics: Actinobacillus Infections; Adult; Female; Humans; Periodontal Diseases; Pseudotumor Cerebri; Tetracycline

Actinobacillus actinomycetemcomitans is an oral bacterium which is being encountered with increasing frequency in infective endocarditis. This organism occurs in high numbers in periodontitis lesions of patients with localized juvenile periodontitis (periodontosis). It is present infrequently, and only in low numbers in most other individuals. Its common resistance to penicillin, erythromycin and vancomycin represents a clinical problem in patients at risk of developing endocarditis after dental treatment. However, the high activity of tetracyclines against A. actinomycetemcomitans may be useful in prophylactic endocarditis considerations by allowing a suppression of the organism prior to the institution of recommended prophylactic protocols. In this study, we determined the effect of systemic tetracycline-HCl therapy (1 gm/day) on the oral A. actinomycetemcomitans population in five localized juvenile periodontitis patients who were heavily infected with the organism. A. actinomycetemcomitans could not be detected in samples of subgingival and supragingival dental plaque and cheek mucosal surfaces following 14 days of administration of systemic tetracycline. The organism was still undetectable 3 weeks after therapy but it reappeared at a few oral sites at week 8 post-treatment. On the basis of this data, it is proposed that the prophylactic endocarditis therapy of patients with high numbers of penicillin-resistant A. actinomycetemcomitans include a two-stage approach: first, the systemic administration of tetracycline for 14 days, and second, institution of a conventional prophylactic protocol during the time of dental treatment.

Topics: Actinobacillus; Actinobacillus Infections; Adolescent; Dental Plaque; Endocarditis, Bacterial; Female; Humans; Male; Mouth Diseases; Periodontitis; Tetracycline

Topics: Actinobacillus Infections; Adolescent; Animals; Bites and Stings; Horses; Humans; Male; Tetracycline

Topics: Actinobacillus; Actinobacillus Infections; Fistula; Humans; Intestinal Fistula; Lumbosacral Region; Male; Middle Aged; Retroperitoneal Space; Skin Diseases; Tetracycline

Topics: Actinobacillus Infections; Ampicillin; Bacteria; Child; Child, Preschool; Chloramphenicol; Empyema; Female; Haemophilus Infections; Humans; Infant; Male; Meningitis, Haemophilus; Microbial Sensitivity Tests; Osteomyelitis; Penicillin Resistance; Peritonitis; Tetracycline

Topics: Actinobacillus; Actinobacillus Infections; Animals; England; Kidney; Kidney Cortex; Kidney Medulla; Necrosis; Swine; Swine Diseases; Tetracycline