Like adults, child patients are also prescribed various therapeutic agents befor e, during and after dental

treatment. Therapeutic agents are used in children f or various purposes To calm the child To remove anxiety To relieve pain To treat infection To decrease swelling and inflammation To control any allergic reactions. Generally therapeutic agents are given along with dental treatment to get better and quick results so that patient experiences less discomfort and pain during a nd after any procedure. The rationale for choice and use of antibiotics begins with the review f o likely microorganisms responsible for common orofacial infections. HISTOROY The history of antimicrobials begins with the observations of Pasteur an d Joubert, who discovered that one type of bacteria could prevent the growth of another (1877). During the later part of 10th century and the early years of twentienth centry, several antimicrobial substances were demonstrated in bacteria culture a nd some were even clinically tested but discarded because they proved to be high ly toxic. The modern era of antimicrobial therapy started with the clinical use of sulfonamides in 1936. The golden age of antibiotics began with the production o f penicillin in 1941. it was discovered in 1929 by the English Bacteriologist A lexander fleming, he observed that colonies of the bacterium staphylococcus arur eus could be destroyed by the mod Penicillium notatum, demonstrating antibacteri al property. 1935 Pantosil, the first sulfadrug, was discovered in 1935 by German chmist Gerh ard Domagk (1895-1964). 1942 The manufacturing process for Penicillin and Procaine was invented by Howar d Florey and Ernst Chain. NB: 1945 Fleming, Florey and chain shared the Nobel Prizee for medicine for thei r work on penicillin. 1943 American microbiologist Selman Waksman made the drug streptomycin from soil bacteria, the first of a new class of drugs called aminoglycosides. 1955 Tetracyclin was patented by Lloyd Conovor. 1981 Smithkline Becham patented Amoxicillin or amoxicillin/clavulanate potassium tablets, and first sold the antibiotic in 1998 under the tradname of Amoxicilli n, Amoxil and Trimox. Atleast 30% of all hospitalized patients now receive one or more courses of therapy wi8th antibiotics and millions of potentially fatal infections have been cured. However at the same time these agents are among the most misudes by the practicing physician. DEFINITION AND CHARACTERISTICS Antibioticsi are substances produced by microorganisms whch selectively suppress the growth of or kill other microorganisms at very low concentrations. This definition excludes other natural substances which also inhibit microorgan isms but are produced by higher forms (eg: Antibodies) or even those produced by microbes but are needed in high concentrations (ethanol, lactici acid, H2O2). Initially the term chemotherapeutici agent was restricted to synthetic com pounds, but now since many antitibiotics and their analogues have been sensitisi zed, this criterion has become irrelevant; so both synthetically and micorobiolo gically produced drugs need to be included together. It would be more meaningful to use the term Antimicrobial agent (AMA) to designate soiynthertic as well as n aturally obtained drugs that alternate microorganisms.

MISUSE OF ANTIBIOTICS Antibiotics are prescribed in dental practice for prophylactic and thera peutic reasons. Prophylactic antibiotics are prescribed to prevent diseases cau sed by members of the oral flora introduced to distant sites in a host at risk i ntroduced to a local compromised site in a host at risk. In most cases prophylaxis i8s used for prevent ion of endocarditis. The rpaieutic antibiotics are prescribed, in most cases to treat diseases of the har d and soft tissues in the oral cavity after local debridement has failed. Antib iotics are prescribed for oral conditions related to endodontic, oral surgical, and periodontal manifestations. Unwarrnted use of antibiotics are reported in children mostly for ear an d dental infections. In children increasing microbial resistance to antibiotics i is a well-documented and is a serious global health concern. Antibiotic resistance is due to inappropriate use of antibiotics by clin icians. Antibiotic misuse in dentistry mainly involves presorbing them is inappr opriate late situations or for too long, period