Effect Of Betamethasone And Diclofenac Sodium On Serum And Tissue Concentration Of Amoxicillin. In Vivo Study In Rats

Objective: Antimicrobial agents in combination with anti-inflammatory drugs have been usually prescribed in both Medicine and Dentistry. However, few scientific reports support this clinical practice. The aim of this study was to evaluate the effect of betamethasone and diclofenac sodium on serum and tissue concentration of amoxicillin in rats. Methods: Four polyurethane sponges were implanted in the back skin of 48 rats. After seven days the animals were divided into 6 groups (n=8). Group 1: amoxicillin (25 mg/kg); G2: diclofenac sodium (2.5 mg/kg); G3: betamethasone (0.1 mg/kg); G4: diclofenac sodium and amoxicillin; G5: betamethasone and amoxicillin; and G6: 0.9% sodium chloride solution (1.0 mL - control group). All drugs were administered in a single dose. After 90 minutes, the granulomatous tissues of each animal were surgically removed and weighed. Blood was collected from cervical plexus, centrifuged and 10μL of serum was placed on paper discs. In order to estimate amoxicillin concentration, serum and granulomatous tissues were separately submitted to microbiological assay, which used 108cfu/mL of Staphylococcus aureus ATCC 25923 (penicillin-susceptible strain). After incubation (18 hours, 37°C) the inhibition zones were measured and compared to a regression curve. Results: No inhibition zones were observed for groups 2, 3 and 6. Tissue and serum concentrations of both G1 (4.14μ g/g and 2.06μ g/mL, respectively) and G5 (3.87μ g/g and 1.70μ g/mL, respectively) showed statistically significant differences (Kruskal-Wallis, p<0.05) in comparison to G4 (1.45μ g/g and 0.41μ g/mL, respectively). G1 and G5 did not differ significantly (p>0.05). Conclusion: Considering single doses, betamethasone did not interfere with amoxicillin levels but diclofenac sodium reduced both tissue and serum levels of amoxicillin in rats.145319323Agarwal, G., Awasthi, S., Kabra, S.K., Kaul, A., Singhi, S., Walter, S.D., Three day versus five day treatment with amoxicillin for non-severe pneumonia in young children: A multicentre randomised controlled trial (2004) BMJ, 328, p. 791Alexander, R.E., Throndson, R.R., A review of perioperative corticosteroid use in dentoalveolar surgery (2000) Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 90, pp. 406-415Baglie S, Groppo FC, Mattos-Filho TR. Tissue pharmacokinetic of amoxicillin. An experimental design in rats. 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Antimicrobial Resistance Of Staphylococcus Aureus And Oral Streptococci Strains From High-risk Endocarditis Patients

This study sought to determine the antimicrobial susceptibility of Staphylcoccus aureus and viridans group streptococci strains collected from the forearm skin and saliva of 30 patients at high risk of endocarditis. Agar susceptibility tests of antibiotics routinely utilized in dentistry were used to verify antimicrobial resistance of bacterial strains. Of the Staphylcoccus aureus strains, 50% were resistant to ampicillin, 53.3% to amoxicillin, 60.0% to penicillin G, 13.3% to amoxicillin/clavulanate, 20.0% to azithromycin, 27.6% to clarithromycin, 23.3% to erythromycin, 3.3% to cefazolin, and 6.7% to clindamycin. Regarding streptococci, 16.7% of the strains were resistant to ampicillin, 16.7% to amoxicillin, 23.3% to azithromycin, 23.3% to clarithromycin, 30.0% to erythromycin, 13.3% to cefazolin, 26.7% to clindamycin, 16.7% to penicillin G, and 3.3% to amoxicillin/clavulanate. Pathogens associated with bacterial endocarditis exhibited elevated resistance rates against the antibiotics used for prophylaxis in dentistry.536410413Benn, M., Hagelskjaer, L.H., Tvede, M., Infective endocarditis, 1984 through 1993: A clinical and microbiological survey (1997) J Intern Med, 242, pp. 15-22Mansur, A.J., Grinberg, M., Gallucci, S.D., Bellotti, G., Jatene, A., Pileggi, F., Infective endocarditis: Analysis of 300 episodes (1990) Arq Bras Cardiol, 54, pp. 13-21Ruiz Jr., E., Schirmbeck, T., Figueiredo, L.T., A study of infectious endocarditis in Ribeirao Preto, SP-Brazil. Analysis of cases occurring between 1992 and 1997 (2000) Arq Bras Cardiol, 74, pp. 225-231Dajani, A.S., Taubert, K.A., Wilson, W., Bolger, A.F., Bayer, A., Ferrieri, P., Gewitz, M.H., Zuccaro Jr., G., Prevention of bacterial endocarditis. 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