A clinical study on CZX for assesment of a prophylactic effectiveness against post-operative infection in oral surgery was carried out. CZX was administered by intravenous injection to 34 patients (Group I; 18 cases of progenia, Group II; other 16 cases) after surgery. The fever index was calculated by the method of Ledger. A total score for objective evaluation of postoperative infection was determined based on the sum of scored clinical data for body temperature, leucocyte count, ESR, CRP and bacterial appearance. The higher the score, the higher was the possibility of post-operative infection. The following results were obtained :
1) The fever index was 7.44±9.85 degree hours in total cases, 13.2±10.50 degree hours in Group I, and 0.98±1.99 degree hours in Group II.
2) According to the total score for prophylactic effectiveness, out of 34 cases, 8, and 2 cases had 1, 2, and 3 points. The remaining 16 cases had 0 points.
3) Post-operative clinical courses, such as a dehiscence and infection of surgical wound were not observed.
4) No side effects were detected.
Based on the present results, CZX appeares safe and quite useful for preventing post-operative infection in oral surgery.

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Secondary thrombocytopenia was defined as a decrease in the platelet count to less than 3×10⁴ mm³ and it was induced by Latamoxef (LMOX) administration. A 21 year-old male received a segmental resection of the mandible and a reconstructive surgery due to the calcifying odontogenic cyst. The patient was given totally 23 g of LMOX during 8 days after operation, which was intravenous administrated 2 to 3 g per day. The platelet cout was markedly decreased at 8th day after operation to 0.4-0.7×10³/mm³, and petechia and ecchymosis were noticed in skin. The patient was cut off the administration of LMOX, and he was recovered platelet count 2 days after giving predonin.

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Clinical studies of Cefdinir (CFDN : FK 482) in the treatment of infections in the oral surgery were evaluated, and the antibacterial activities of CFDN against oral streptococci were determined. These results were obtained as follows :
1. Against 125 strains of oral streptococci MIC₅₀ and MIC₉₀ of CFDN were 0.05μg/ml and 0.2μg/ml, respectively. The antibacterial activity of CFDN was equal to that of Cefpodoxime and Cefroxime.
2. CFDN was orally adiministered to a total of 177 patients in a dose of 100 mg or 200 mg t, i. d.. The subjects consisted of the patients with periodontitis (Group I), pericoronitis (Group II), and osteitis of the jaw (Group III) . 174 patients were evaluated for efficacy, and 175 patients were evaluated for safety and usefulness.
The clinical efficacy rate judged by the comparative score evaluated on Day 3 was 90.8 %. While, rate by the investigators was 86.8 %. When these rates were evaluated for each disease group, the efficacy rates by the comparative score evaluated on Day 3 and by the investigators were 91.5 % and 88.1 % in Group I (59 cases), respectively, 87.5 % and 85.0 % in Group II (40 cases) and 92.0 % and 86.7 % in Group III (75 cases), respectively. In clinical efficacy rate based on comparative score evaluated on Day 3 for each dose level, the efficacy rates were high in both the 300 mg group (90.4 %) and 600 mg group (92.1 %) . In patients with high score on the starting day of the treatment, however, efficacy rate in the 600 mg group was somewhat lower than that in the 300 mg group.
3. On the bacteriological effect, eradication rate was 94.3 %.
4. A total of 174 strains of organisms were isolated from patients. (Streptococcus spp.: 87, Peptostreptococcus spp.: 46, Bacteroides spp.: 14 and others : 27)
The MIC₅₀ and MIC₉₀ of CFDN for all the isolates were 0.05 and 0.39 μg/ml, respectively.
5. Adverse events were observed in 7 of the 175 patienst : gastrointestinal tract disorders in 6 and eruption in 1. Abnormal findings in laboratory tests were noted in 7 of the 175 patients. They were an increase in eosinophl (4) and GOT and GPT (1), and GPT (2) . No serious events were seen in any of the patients.
6. Usefulness rate (“useful”or better response) that evaluated by investigators was 86.9 %. From the above results, CFDN was considered to be useful in the treatment of infections in Dentistry and Oral Surgery. As for the standard dose, 100 mg t, i, d, proved to exert the expected effects.

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The blood concentration of CFDN in wound after tooth extraction and oral tissues after single adiministration with 100mg were determined, and the results were obtained as follow:
1. CFDN was administered to a total of 153 patients before exraction, and 164 specimens were collected. When the concentration was set at MICs of oral streptococci (0.2μg/ml) or Peptostreptococcus spp. (0.1μg/ml) as a target level, 39 in the 164 samples (23.8 %) achieved over 0.2μg/ml and 73 (44.5 %) over 0.1μg/ml.
2. The penetration of CFDN into oral tissues was determined in 15 patients. The concen-tration in gingiva ranged from <0.016 (under the measurable limit) to 0.959μg/ml in 14 patients, mean ± S.D. value was 0.282±0.272pg/g in 11 patients excepted three (<0.016μg/g) from all 14 patients.
The concentration in cyst wall ranged from 0.088 to 0.519μg/g, being 0.367+0.200μg/g in average. The transfer ratio of gingiva tissues to the serum ranged from 0.66 to 1.99, and its ratio of cyst wall ranged from 0.27 to 1.05, with good penetration.
From the above results, concentration of CFDN in wound after tooth extraction was somewhat low, but good penetration into oral tissues was obtained.

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Although many reports have described the information sources used by drug information pharmacists, little has been written about dental drug information services and their information sources. The USP-DI Drug Information for the Health Care Professional includes Dental Precaution Listing since 1986. We surveyed the content and usefulness of this appendix and compared it with other information sources. Dental Precaution Listing contained approximately 530 drugs in 1990 th edition. We consider most of the those precautions as noteworthy, but USP-DI categolized drugs that might alter taste sensation and cause gingival hyperplasia, differently from the other information sources.
The dental information service is not a well-developed specialty yet, and practitioners rely heavily on the few relevant resource books available. We consider that the listing in USP-DI is one of those sources.

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Some of the oral antibiotics which have been developed recently are prodrugs, aiming at im-provement of bioavailability.
These drugs are said to be hardly subject to food and are more smoothly transferred into blood when they are administered after having food. We have conducted a comparative study on a prodrug type-new cephem oral antibiotic, cefuroxime-axetil (CXM-AX) recently approved for the clinical indication in the area of dentistry and oral surgery, vs a non prodrug type cephem oral antibiotic, cefaclor (CCL), commonly used in the field of dentistry to examine influence of food on transfer of the orally given drugs into blood in healthy volunteers.
Results
1) In CXM-AX administration group, the serum concentration attained the peak 0.5 hour later in the group which took the drug after having food and the peak concentration was 1.6 times higher in the same group, compared with the group which took the drug at fasting.
2) In CCL administration group, the serum concentration attained the peak 0.94 hour later in the group which took the drug after having meal, and the such concentration was about twice as higher at fasting, compared with the counterpart group.
3) From the above, it was concluded that CXM-AX is hardly subject to influence of food, and it's transfer rate into blood is higher when it is administered after having meal, whereas, CCL transfer into blood is more subject to influence of food.

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Dental treatments involving mucosal surface or contaminated tissue commonly cause transient bacteremia. The latest chemoprophylactic regimen recommended by the American Heart Association for prevention of infective endocarditis, published in December 1990, shows that clindamycin is useful to patients allergic to penicillins and cefems. To our enquiry about why clindamycin is used, however, the AHA replied that the effect of this Burg was based on empirical evaluation and that they had no basic test data. On enquiring the manufacturer of this drug (Upjohn Pharmaceuticals Limited.), we found that they did not have basic test data, either.
The materials were limited to the microorganisms isolated from samples that were collected from closed abscesses caused by odontogenic infection at 12 institutions during treament with cefpodoxime proxetil from October 1990 to September 1991.
Samples were gathered from 93 patients and 221 strains were indentified. MICs were determined for three kinds of antimicrobial agents : clindamycin, cefaclor, an agent most commonly used in Japan, and amoxicillin which is most highly recommended by the AHA.
Compared on the basis of MIC₉₀, clindamycin showed the lowest MIC of MIC₉₀≤0.05μg/ml while MIC₉₀ of amoxicillin was 0.2 μg/ml and that of cefaclor 6.25 μg/ml.
The MIC levels of clindamycin were lower than those of the two other agents. This suggests that clindamycin can be used for chemoprophylaxis in dentistry and oral surgery.

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The clinical efficacy and safety of ME1207 as a treatment for odontogenic infections such as periodontitis, pericoronitis and osteitis was evaluated in 9 institutions.
The results were as follows :
1) Clinical efficacy :
The overall clinical efficacy rate determined according to the standards established by the Committee was 84.0 %. By disease, the efficacy rates were 76.5 %, 76.9 % and 97.1 % for periodontitis, pericoronitis and osteitis, respectively. The overall efficacy rate assessed by the doctors in charge was 83.0 % and the efficacy rates by diagnosis were 76.5 %, 88.5 % and 85.3 % for periodontitis, pericoronitis and osteitis, respectively.
2) Bacteriological response :
The MIC₅₀ and MIC₉₀ of ME1207 against 100 clinically isolated strains were 0.10 and 0.78 μg/ml, respectively. For 53 aerobes strains, the MIC₅₀ and MIC₉₀ were 0.10 and 0.20 μg/ml. Against 36 strains of oral streptococci, the range of MIC were from ≤0.025 to 0.20 μg/ml.
The MIC₅₀ and MIC₉₀ against 47 strains of anaerobes were 0.10 and 0.78 μg/ml, respectively. The eradication rate against infecting organisms from 46 patients were 73.9 % as judged by old criteria.
3) Safety :
Mild side effects occurred in 6 (6.3%) of the 96 patients treated and slightly abnormal laboratory findings were found in 2 (3.1%) of 64 patients examined.

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Bacteriological studies were carried out in the field of oral and maxillofacial surgery. The total number of isolated organisms were 100 strains.
The results were as follows :
1. Oral streptococci were most frequently datected from dental infections followed by oral group Bacteroides.
2. Of the 46 patients included in this study, 20 had monomicrobial infections and 26 had polymicrobial infections. Polymicrobial infections due to aerobes plus anaerobes were the most frequent, while those due solely to anaerobes were less frequent.
3. The minimum inhibitory concentration (MIC) of ME1206 against oral streptococci ranged from ≤0.025 to 0.20μg/ml and its MIC₉₀ was 0.20μg/ml.
Compared with the other 5 drugs tested, ME1206 proved to be the most effective.
4. MIC₉₀ of ME1206 against Bacteroides and against Peptostreptococcus it was 0.78μg/ml and 0.39μg/ml.
From these results, we concluded that ME1207 is effective against infections in the fields of oral and maxillofacial surgery.

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