Which of the following antibiotics should be avoided in pediatric patients due to the risk of permanent tooth staining?

A Chloramphenicol

B Tetracycline

C Ampicillin

D Erythromycin

Solution

Correct Answer: Option B

The correct answer is Tetracycline.

- Tetracycline antibiotics are well-known for their ability to cause permanent tooth staining when administered to pediatric patients, especially those younger than 8 years old.
- This occurs because tetracycline binds to calcium ions in developing teeth and bones, leading to a characteristic yellow, brown, or gray discoloration of the teeth.
- This staining is often intrinsic and irreversible, affecting both deciduous and permanent teeth.

Additionally, tetracycline may interfere with normal bone growth in children, further limiting its use in the pediatric population. For these reasons, clinicians typically avoid prescribing tetracycline to children and pregnant women.

In contrast, other antibiotics listed such as chloramphenicol, ampicillin, and erythromycin do not cause permanent tooth discoloration and are generally considered safer options for use in pediatric infections.

Key points:
- Tetracycline binds to calcium in developing teeth and bones.
- Causes permanent intrinsic tooth discoloration (yellow-brown-gray staining).
- Not recommended in children under 8 years and in pregnant women.
- Other antibiotics listed do not induce tooth staining.

Reference: Harrison's Principles of Internal Medicine, 20th Edition, Volume 2, Infectious Diseases Chapter, p. 1250

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