الفهرس 
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Abstract
Children are frequently subjected to liquid medications, especially antibiotics.
Children with chronic diseases are subjected to these medicines daily. They are acidic, have
high titratable acidity, and low pH. This can exert an erosive effect on tooth structure by
repeated exposure.
Aim: To determine the correlation between commonly prescribed antibiotics as regards their
erosive effect and the frequency of intake on primary enamel integrity.
Materials and Methods: Three groups of antibiotics were selected after performing a pilot
study among health care providers to determine commonly prescribed antibiotics in children.
It proved that prescriptions were mainly macrolides, cephalosporins and mixed composition.
The titratable acidity and the pH of the artificial saliva and selected antibiotics were
determined. Freshly exfoliated or extracted primary teeth were assigned randomly to one of
the four groups, according to the type of antibiotic used and to the selected control group.
Specimens were immersed in fresh solutions of antibiotics for 1 minute over 3, 5and 10 days
period, depending on the type of antibiotic. All samples were preserved in artificial saliva in
between immersion cycles. The control group was immersed in artificial saliva. Enamel micro
hardness was evaluated at baseline, 3&5 days for macrolides and 5&10 for cephalosporins
and mixed antibiotics.
Results: Highest percent reduction was recorded for the mixed antibiotic (24.39 ±4.65),
p<0.0001, followed by cephalosporin (13.79 ±4.37) p<0.0001, macrolides (7.99 ±2.82)
p<0.0001. Mixed type immersed for 10 days showed highest decrease in microhardness
(37.00 ±4.71) p<0.0001. Macrolides for 3 days showed the lowest decrease (12.22 ±3.20). All
the study groups recorded decrease in microhardness p<0.0001.
Conclusion: Tested antibiotics have an enamel erosive action even when pH is above critical,
and low titratable acidity. Increasing duration and frequency of prescription, increases the
erosive potential.
Keywords: Antibiotics, Enamel erosion, Microhardness.