Azithromycin
Common brand names: Zithromax
Dental uses: Azithromycin is an antibiotic related to erythromycin, with a much longer duration of action. Its main use in dentistry (like clarithromycin) is in patients who are allergic to penicillins and who also are at risk of developing bacterial endocarditis (a serious and potentially fatal heart infection) following dental procedures likely to induce mucosal or gingival bleeding. Such procedures include dental extractions, periodontal surgery, professional cleanings, orthodontic band (not bracket) placement and some other procedures. Patients considered at risk are those with prosthetic heart valves, those with mitral valve prolapse with valvular regurgitation (a heart murmur with leaky valves) and those who previously contracted endocarditis, in addition to people with some other cardiac conditions.
Azithromycin also is given to people allergic to penicillins and those who have abscesses and other dental infections, especially those extending into the sinuses, gums and bone, and for whom other antibiotics have proved ineffective.
Dosages for dental purposes: The recommended dose for preventing endocarditis is 500 milligrams one hour before the dental procedure. For penicillin-allergic patients with dental infections, azithromycin is prescribed at a dosage of 500 milligrams on the first day, and then 250 milligrams every 24 hours for a total of five days. Dosages for children are based on body weight.
Concerns and possible side effects: Although more expensive than erythromycin, azithromycin causes fewer gastrointestinal complaints such as abdominal pain, nausea, vomiting and diarrhea. So far, azithromycin has not been shown to cause the same serious drug interactions as erythromycin or clarithromycin
