Flomoxef (FMOX) of 1 g was administered to 29 patients respectively by intravenous bolus injection. The distribution to oral tissues of FMOX and the pharmacokinetic analysis of the maxillary and mandibular bones were performed.
The following results were obtained.
1) The concentrations of FMOX in the serum were 57.6μg/ml, 36.7μg/ml, 18.4μg/ml, 7.70μg/ml, 1.97μg/ml and 0.50μg/ml at 15 minutes, 30 minutes, 60 minutes, 120 minutes, 240 minutes and 360 minutes after injection, respectively. T_1/2 (β) was 1.04 hour, and AUC was 66.8μg⋅hr/ml.
2) The concentrations of FMOX in the maxillary and mandibular bones were 6.07μg/g, 5.15μg/g, 2.59μg/g, 0.98μg/g and 0.25μg/g at 15 minutes, 30 minutes, 60 minutes, 120 minutes and 240 minutes after injection, respectively, and ranged from 10 to 14% of the serum level. T_1/2 was 0.28 hour, and C_max was 6.10μg/g.
3) The concentrations of FMOX in the cyst wall, gingiva and nasal mucosa ranged from 30 to 90% of the serum level.

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Basic and clinical studies were carried out to evaluate the usefulness of Ciprofloxacin (CPFX) in the field of oral and maxillofacial surgery, and the following results were obtained.
1) The MIC₅₀ of CPFX against 68 Streptococcus sp. clinically isolated was 1.56μg/ml and the MIC₈₀ was 3.13μg/ml thereto. Both of the MIC₅₀ and MIC₈₀ of CPFX against 7 Staphyrococcus sp. were 0.78μg/ml.
2) Oral tissues in rabbits showed their peaks at 1 hour after oral administration of 20mg/kg. The levels in oral soft tissues were superior to those in serum. Especially, in salivary gland and gingiva, higher levels were found among soft tissues. Jaw bone levels, however, were inferior to serum levels. The penetration of CPFX into oral tissues in human was determined 1.5 to 7 hours after oral administration of 200mg. The levels in gingiva ranged from 0.28 to 2.09μg/g (2-4.5hours) and were almost the same as those in serum. Most of the levels of jaw bone, however, were inferior to those of serum.
3) With administration of CPFX at a daily dose of 600mg into 27 odontogenic infection cases, the clinical efficacy rate was 85.2% (23/27) .
4) It was considered that CPFX was effective in the treatment of mild and moderate odontogenic infections.

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A combination therapy of clindamycin phosphate (CLDM) with ceftazidime (CAZ) was used in 2 cases of acute odontogenic infections. In the first case, 2 isolated bacteria strains were Peptostreptococcus micros and β lactamase-producing Prevotella oralis. In the second case, 4 isolated strains were Streptococcus constellatus, P. micros, Porphyromonas gingivalis and, β lactamase-producing Bacteroides capillosus. β lactamase-producing bacteria in two cases were highly sensitive to combination therapy of CLDM with CAZ. In conclusion, combination therapy of CLDM with CAZ is useful for speeding recovery and effective in oral suppurative mixed infections with β lactamase-producing bacteria.

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Cepharanthin, a biscoclaurin alkaloid preparation extracted from Stephania cepharantha, is reported to exert a biological membrane stabilizing effect, antiallergic effect, and immunoen-hancing effect. This preparation is also considered to stimulate hematopoietic stem cells but inhibit activated oxygen production in polymorphonuclear leukocytes (PMNs) . In the field of dental medicine, this drug is used in the treatment of aphthous stomatitis, lichen planus and glossalgia. This study was conducted to determine the effects of this preparation on PMN phagocytosis. PMN phagocytosis was assessed with PMNs isolated from peripheral blood obtained from 5 healthy men who had not taken any medicine for the preceding 3 months. Serum combined with phosphate buffered saline solution containing Cepharanthin at concentra-tions of 0 (control group), 0.5, 1, 10 and 50μg/ml, was added to the PMNs. Fluorescein isothiocyanate-labelled beads were added as a maker for phagocytosis, and the specimen groups were incubated at 37°C for 5, 10, 20 and 30 min. After fixation, 5000 cells from each incubated group were examined by flow cytometry for their phagocytosis index and the number of maker beads ingested per cell ; the results were analyzed statistically. The phagocytosis index in evecy group showed time-dependent increases from 5 to 30 min of incubation. The increase in the Cepharanthin-treated groups was higher than that in the control (untreated) group. There were statistically significant differences (significance level, 5%) between the 0.5μg/ml Cepharanthin-treated group and control group, and between the 50pg/ml group and control group, at incubation periods of 10 and 20 min, respectively. Although the number of marker beads ingested per cell every group tended to decrease at 5 min of incubation they increased after that. No significant differences were found between the incubated groups. The above results indicate that Cepharanthin stimulates a biophylactic function by enhancing PMN phagocytosis in human peripheral blood.

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The quantity of non-steroidal anti-inflammatory drugs (NSAIDs) and anti-inflammatory enzymatic drugs used at 29 Japanese dental hospitals was investigated using questionnaires.
Of the 29 hospitals, 11 were affiliated with national universities, 17 were affiliated with private dental colleges or universities and one was affiliated with a public dental college.
The three NSAIDs dispensed mostly over a 10-day period and purchased mostly over a 6-month period and evaluated during 1992 were loxoprophen sodium, diclofenac sodium and mefenamic acid.
Rated by chemical structure, the drugs classified as propionates (Loxonin^®, Orudis^®, Froben^®, Niflan^®, Brufen^®, Minalfen^®) had highest use (46.9%) while allyle acetates (Voltaren^®, Docell^®, Fenazox^®, Infree^®, Indacin^®, Inteban^®, Clinoril^®) were next at 32.3%.
There was little variation found among the hospitals in the use and purchase of the anti-inflammatory enzymatic drugs.
The three drugs dispensed mostly over a 10-day period were, in order, 30 mg lysozyme chloride, 5mg serrapeptase and 9000 IU pronase.
The anti-inflammatory enzymatic drugs purchased mostly over a 6-month period were, in order, 5mg serrapeptase, 30 mg lysozyme chloride and 50 mg lysozyme chloride.
Although the combined use of two NSAIDs is contraindicated due to side effects, such a combined use was observed in few hospitals.

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In an effort to survey antimicrobial agents actually used in dental practice, a multiinstitutional study was made of the consumption and share of antimicrobial agents as classified by chemical structure and dosage form. The study involved 29 dental colleges or university hospitals in Japan, and consisted of two parts: one, investigation of the share of antimicrobial agents used in a 10-day period from 28th September through 9th November, 1992, and the other, categorization of antimicrobial agents used over a 6-month period from April through September 1992.
Antimicrobial agents accounted for 22% of all oral medicines, and ranked second just behind antiinflammatory and analgesic drugs which accounted for 27%. The order of share in descending frequency was: cephem series including Cefaclor and Cephalexin ; penicillin series such as Lenampicillin, Amoxycillin, and Bacampicillin. Injectable antimicrobial agents were used in as many as 62% of patients who were given injectable forms. The breakdown is as follows: cephem series, 50%; penicillin series, 27%; and others comprised of fosfomycin, aminoglycosides and tetracycline series, only 14%.
Cephem and penicillin preparations were found to constitute the most commonly uded antimicrobial agents in dental practice, with this trend shared by all dental colleges and university hospitals in Japan.

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The venous blood samples were cultured to determine the incidence of transient bacteremia immediately after tooth extraction. Cultured positive rates were 27 (69.2%) out of 39 tested cases. The isolated organisms were 47 strains, while oral streptococci occupied 18. Anaerobic organisms such as genus Gemella and genus Peptostreptococci included, 35 (74.4%) out of 47 isolated strains belonged to streptococci group MICs were tested on 7 antimicrobial agents; ampicillin, penicillin V, cefteram (cefteram pivoxil is the substance), cefpodoxime (cefpodoxime proxetil is the substance), erythromycin, ofloxacin and tosufloxacin. The susceptibilities of ampicillin and cefteram were excellent. Considering the high figure incidence (69.2 %) of transient bacteremia after tooth extraction, we should apply chemopro-phylaxis to a wider range of other patients other than those who have heart disease.

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A single oral dose of 100 mg of cefdinir (CFDN) was administrated to 107 patients and the effusion concentration of CFDN at the wound site after exodontia was determined. When the concentration was set at 0.1 μg/ml (MIC₉₀) as a chemoprophylactic target level, all cases had obtained a higher corcentration than the target level during 60-490 minutes after the administration.
From these results, it is indicated that CFDN is a useful agent for prophylaxis and treatment of odontogenic infections.

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