PENETRATION OF ANTIBIOTICS INTO ORAL TISSUE TO DIABETIC DESEASE

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The fact that diabetics are susceptible to infections and worsening of periodontal disease is common knowledge, and in the routine clinical practice of oral surgery antibacterial agents should always be administered whenever diabetics are subjected to invasive oral treatment, such as tooth extraction. However, it is thought that microcirculatory disorders develop in diabetics in association with the progression of diabetic microangiopathy in the capillaries of the oral mucosa, the same as in the retina, and thus it was predicted that the concentrations of antibacterial agents that penetrate the oral mucosa would be lower than in healthy persons. The subjects of this study were diabetics who were examined in the oral surgery department of Tokyo Women's Medical College and underwent tooth extraction. Oral antibacterial agents were administered to them, blood and gingiva specimens were collected during the procedure, and the concentrations of the antibacterial agents in the serum and ging … More iva were measured by bioassay. The results of measuring concentrations of cefacrol in 35 patients and lomefloxacin hydrochloride in 30 patients have been obtained this far. The values for cefacrol in the gingiva within 1 h after ingestion were : maximum, 1.67mug/g ; minimum, 0.09mug/g ; mean, 0.828(]SY.+-。[)0.500mug/g ; between 1 and 2 h after oral administration the values were : maximum, 7.98mug/g ; minimum, 0.4mug/g ; and mean, 2.038(]SY.+-。[)1.691mug/g. When lomefloxacin hydrochloride was administered to the diabetics, the serum concentration was 0.22-1.97mug/ml and the gingival concentration was 0.20-2.93mug/ml and the serum of wound after extraction concentration 0.30-3.04mug/ml, as opposed to a serum concentration of 0.47-3.76mug/ml and a gingival concentration of 0.13-2.00mug/g and the serum of wound after extraction concentration of 0.24-2.65mug/g in the healthy subjects. However, none of the differences between them were significant. A larger series of cases and a more detailed study will be needed in the future. Less