Evaluation of Drug Susceptibility of Microorganisms in Odontogenic Inflammations and Dental Surgery Procedures Performed on an Outpatient Basis

Abstract

Bacterial infections are the most common cause of purulent soft tissue inflammations in the head and neck area. These bacteria are also responsible for the majority of inflammatory complications after third molar removal. The key to success of antibacterial treatment in both cases is the use of an appropriate antibacterial agent. The aim of the study was to evaluate the susceptibility profile of bacteria isolated from material collected from patients with intraoral odontogenic abscesses. The test material consisted of swabs taken from the odontogenic abscesses, after their incision and drainage. Another swab was collected from the lesion area, 10 days after the initial visit. Results were compared with an identical study conducted on a control group of healthy patients, who had undergone third molar removal. Bacteria identified in this study consisted of aerobic and anaerobic strains, both Gram-positive and Gram-negative. According to the EUCAST guidelines, none of the tested antibiotics was recommended for all identified bacteria. The percentage of bacterial strains sensitive to amoxicillin and clavulanic acid was 78.13% and 81.48% in the study and control groups, respectively, whereas, the percentage of those sensitive to clindamycin was 96.43% and 80.00%, respectively. For Gram-negative aerobic bacteria, gentamicin and ciprofloxacin were among medications affecting all cultured species. 100.00% of strains were found to be susceptible to these antibiotics. Statistically significant relationship between the presence of Gram-negative aerobic strains and the occurrence of complications was found. In the case of the most frequently occurring bacteria in the study, amoxicillin with clavulanic acid and clindamycin were shown to be very effective. In cases of severe purulent odontogenic inflammations, it is recommended to use a combination of antibiotics. Amoxicillin with ciprofloxacin and clindamycin with cefuroxime seem to be the proper choices based on the results of this study.

Clindamycin as an Alternative Option in Optimizing Periodontal Therapy

“…For example, the susceptibility profile of microorganisms present in the oral environment, both Gram-positive and Gram-negative aerobes isolated from intraoral odontogenic abscesses was 78.13% and 81.48% for amoxicillin and clavulanic acid, the standard regimen; however, for clindamycin, it was 96.43% and 80.00%, respectively. Gentamicin and ciprofloxacin had the highest susceptibility profile for Gram-negative aerobes as all strains were found to be sensitive [30].…”

Protective Effects of Liposomal Curcumin on Oxidative Stress/Antioxidant Imbalance, Metalloproteinases 2 and -9, Histological Changes and Renal Function in Experimental Nephrotoxicity Induced by Gentamicin

“…The use of gentamicin, in parenteral administration, has shown significant better infection outcomes involving some gram-negative bacteria such as Escherichia coli , Klebsiella pneumoniae , Pseudomonas aeruginosa , and was also efficient against some other strains such as Neisseria [ 5 , 6 , 7 ]. Gentamicin also proved to be efficient in bacterial septicemia, meningitis, peritonitis, endocarditis, pneumonia, urinary tract infections, or odontogenic infections [ 8 ]. Local antimicrobial resistance and side effects of Gentamicin’s clinical use are important to consider before Gentamicin treatment initiation.…”

Eficácia da Profilaxia Antibiótica na Terapêutica Odontológica: Revisão Sistematizada

“…Devido à diversidade de espécies presentes na microbiota bucal, as infecções bacterianas são uma das principais causas para o desenvolvimento de afecções purulentas na região de cabeça e pescoço 1 . Como métodos terapêuticos, os fármacos antimicrobianos são um dos principais medicamentos administrados frente a essas infecções, com propriedades bacteriostáticas e bactericidas 2 .…”

“…Na Odontologia, corriqueiramente, essa droga é utilizada como mecanismo terapêutico de uso profilático no combate a possíveis infecções sistêmicas no pré e pós operatório 3 . Em razão disso, é de suma importância o conhecimento dos mecanismos de ações desses fármacos e a disseminação do conhecimento em todas as modalidades dos cursos odontológicos, sendo imprescindíveis para a prevenção de doenças como otite média aguda e a endocardite bacteriana 1,3 .…”