Introduction: Odontogenic infections may lead to severe head and neck infections with potentially great health risk. Age, location of purulent affected sites and beta-lactam allergy are some mentionable factors regarding patients' in-hospital stay and course of disease. Are there new challenges regarding bacteria' antibiotic resistance for empiric treatment and what influences do they have on patients' clinical course?
Methods: We analyzed in a 4-year retrospective study the medical records of 294 in-hospital patients with severe odontogenic infections. On a routine base bacteria were identified and susceptibility testing was performed. Length of stay in-hospital was evaluated regarding patients' age, beta-lactam allergy profile, affected sites and bacteria susceptibility to empiric antibiotics.
Results: Length of stay in-hospital was detected to be associated with affected space and penicillin allergy as well (p < 0.05). Isolates presented large amounts of aerobic gram-positive bacteria (64.2%), followed by facultative anaerobic bacteria (gram+/15.8%, gram-/12.7%). Tested ampicillin in combination with sulbactam (or without) and cephalosporins displayed high susceptibility rates, revealing distinguished results regarding clindamycin (p < 0.05). Co-trimoxazol and moxifloxacin showed high overall susceptibility rates (MOX: 94.7%, COTRIM: 92.6%).
Discussion: This study demonstrates ampicillin/sulbactam in addition to surgical intervention is a good standard in treatment of severe odontogenic neck infections. Cephalosporins seem to be a considerable option as well. If beta-lactam allergy is diagnosed co-trimoxazol and moxifloxacin represent relevant alternatives.
Conclusion: Age, allergic profile and bacteria' resistance patterns for empiric antibiotics have an influence on patients in-hospital stay. Ampicillin/sulbactam proves itself to be good for empiric antibiosis in severe odontogenic infections. Furthermore cephalosporins could be considered as another option in treatment. However moxifloxacin and co-trimoxazol deserves further investigation as empiric antibiosis in odontogenic infections if beta-lactam allergy is diagnosed.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jcms.2016.05.019 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Treatment of Post-Septal Orbital Cellulitis due to Odontogenic Infection.
J Craniofac Surg
January 2025
Department of Oral Medicine and Pediatric Dentistry, State University of Londrina, Londrina.
Orbital cellulitis happens when the region behind the orbital septum is affected. It consists an urgency because of its potential risks of complications, such as vision loss, cavernous sinus thrombosis, or Lemierre Syndrome. This article reports a case of a subperiosteal and orbital cellulitis, which had a periapical lesion in the left first molar as it´s focus.
View Article and Find Full Text PDFENT specialists' knowledge and their skills in detecting maxillary sinusitis of odontogenic origin, a cross-sectional study.
Am J Otolaryngol
December 2024
Pediatric Otolaryngology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Background: Odontogenic maxillary sinusitis (OMS) is recognized in literature, but diagnosing it is challenging due to its different and overlapping clinical presentations of it. Misdiagnosis can lead to persistent symptoms and clinical burden. Interestingly, recent guidelines from the American Academy of Otolaryngology-Head and Neck Surgery lack recommendations for dental evaluation in adult sinusitis cases.
View Article and Find Full Text PDFPhage therapy as an alternative strategy for oral bacterial infections: a systematic review.
BMC Oral Health
January 2025
Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Background: Oral infectious diseases, such as dental caries, periodontitis and periapical periodontitis, are often complicated by causative bacterial biofilm formation and significantly impact human oral health and quality of life. Bacteriophage (phage) therapy has emerged as a potential alternative with successful applications in antimicrobial trials. While therapeutic use of phages has been considered as effective treatment of some infectious diseases, related research focusing on oral infectious diseases is few and lacks attention.
View Article and Find Full Text PDFComparative Assessment of the qSOFA, SII, dNLR, and OISS Infection Severity Scores in Diabetic Versus Non-Diabetic Patients with Odontogenic Infections.
Biomedicines
November 2024
Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Odontogenic infections (OIs) can progress rapidly and may lead to severe systemic complications, especially in patients with underlying conditions like diabetes mellitus (DM). This study aims to evaluate the predictive value of inflammatory scores-quick Sequential Organ Failure Assessment (qSOFA), Systemic Immune-Inflammation Index (SII), derived Neutrophil-to-Lymphocyte Ratio (dNLR), and Odontogenic Infection Severity Score (OISS)-in assessing the severity of OIs in diabetic versus non-diabetic patients. A case-control study was conducted on 123 patients diagnosed with OIs.
View Article and Find Full Text PDFDental Antimicrobial Stewardship: Developing a Mobile Application for Rational Antibiotic Prescribing to Tackle Misdiagnosis.
Antibiotics (Basel)
November 2024
Department of Restorative Odontology and Endodontics, School of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Background/objectives: Inexperienced dentists and dental students are especially prone to misdiagnosis, and this represents a huge problem regarding antimicrobial stewardship. We aimed to develop a mobile app for rational antibiotic prescribing in dentistry based on local-systemic symptoms and patient factors, rather than solely on diagnosis, to tackle misdiagnosis.
Methods: The study involved 64 participants, 50 of which were third-year dental students attending a pharmacology course focusing on antimicrobials, comprising lectures and practical sessions without (noAPP group, n = 22) or with (APP group n = 28) the assistance of a mobile application.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!