- 期刊
抗生素做為牙周病治療輔助劑之理論基礎
Antibiotics in the Treatment of Periodontal Disease
摘要
全身性的抗生素治療封於一些牙周感染及相關的疾病是必須的，且對病人有益。但是，牙周炎可因各種微生物或微生物之共同作用而引起，因此現在尚無單一種抗生素或綜合不同的抗生素能解決所有的牙周感染。我們必需瞭解，如果牙齦下病原菌對使用之抗生素有抗藥性，則不但無法制止牙周病的進行，更可能使原有的牙周為更加惡化。本文提供對選擇適當病人及有效的抗生素應注意的原則。重要的是抗生素治療必須基於對與疾病相關的微生物完整分析及對分離出的病原菌作體外抗菌感受性試驗的結果。抗生素治療的目的更要是藉加強機械性牙周病治療及宿主防禦機轉以達到殺死牙齦下微生物來克服感染。目前只有培養方法才能提供所想知的牙周微生物資料。在美國（例如賓州大學牙醫學院）的實驗室可提供此類微生物的分析服務，因此可幫助牙醫師對治療牙周病感染選擇適當的抗生素。在台灣則尚需建立實驗室才能有合乎時效與經濟效益的服務。
並列摘要
Systemic antibiotic therapy may be necessary and benefit patients with some periodontal infections and associated disease. However, it is also known that periodontitis can be caused by a variety of microorganisms or microbial constellations. The current knowledge also indicated that no single antibiotic or combination of antibiotics presently available can resolve all periodontal infections. It must also be understood that utilization of antibiotics to which subgingival pathogens are resistant may fail to arrest periodontal disease progression and may even aggrevate existing disease.This paper presents practical guidelines for selecting appropriate patients for antibiotic therapy and effective antibiotics or combinations of ant:biotics. The important point is that antibiotic therapy should be based on comprehensive microbiological analyses of the disease associated microflora and in aitro antimicrobial susceptibilty testing of isolated pathogens, and should aim to reinforce mechanical periodontal treatment and to support host defenses in overcoming the infection by killing subgingival microorganisms. At the present time, only culturing can provide the desired infomation. In the United States, national microbiological testing services (e. g. Microbiological Test Laboratory at the University of Pennsylvania, School of Dental Medicine) are available which can help dentists formulate appropriate antibiotic therapy for periodontal infections. In Taiwan, we need to establish laboratories to perform the analyses in a timely and economical manner.