<i>In vitro</i> activity of moxifloxacin compared to other antimicrobials against streptococci isolated from iatrogenic oral bacteremia in Spain

Tomás, Inmaculada; Álvarez, Marina Rodríguez; Limeres, Jacobo; Otero, José Luis Rodríguez; Saavedra, Emilio Barrueto; C, López-Meléndez; Dios, Pedro Diz

doi:10.1111/j.1399-302x.2004.00167.x

Cited by 27 publications

(21 citation statements)

References 38 publications

(41 reference statements)

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“…This fluoroquinolone shows good in vitro activity against odontogenic pathogens (23,27,43). Recently, we have found that all the streptococci isolated from a series of patients with iatrogenic bacteremia of oral origin showed a low MIC to MXF (47). Furthermore, we have demonstrated its efficacy in vivo for the treatment of submucous layer dental abscesses, confirming its penetration into tissue in the oral cavity (24).…”

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confidence: 75%

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confidence: 99%

“…Moreover, increasing resistance to CLI among streptococci isolated from the bloodstream after dental extractions has been found (47); this could limit its use as a prophylactic drug.…”

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confidence: 99%

“…MXF has shown good in vitro activity against both oral streptococci (macrolide-sensitive or -resistant) and anaerobic pathogens (23,27,43,47). Recently, we have found in a series of BDE that all the streptococci isolated showed a low MIC to MXF (47). Furthermore, the properties of MXF are favorable both pharmacokinetically (high bioavailability, long half-life, and good tissue penetration) and pharmacodynamically (MXF is bactericidal at concentrations two-to fourfold higher than the MIC) (26).…”

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confidence: 99%

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Comparative Efficacies of Amoxicillin, Clindamycin, and Moxifloxacin in Prevention of Bacteremia following Dental Extractions

Dios

Tomás

Limeres

et al. 2006

Antimicrob Agents Chemother

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We evaluated the efficacies of oral prophylactic treatment with amoxicillin (AMX), clindamycin (CLI), and moxifloxacin (MXF) in the prevention of bacteremia following dental extractions (BDE). Two hundred twentyone adults who required dental extractions under general anesthesia were randomly assigned to a control group, an AMX group, a CLI group, and an MXF group (the individuals in the drug treatment groups received 2 g, 600 mg, and 400 mg, respectively, 1 to 2 h before anesthesia induction). Venous blood samples were collected from each patient at the baseline and 30 s, 15 min, and 1 h after the dental extractions. The samples were inoculated into BACTEC Plus aerobic and anaerobic blood culture bottles and were processed in a BACTEC 9240 instrument. Subculture and the further identification of the isolated bacteria were performed by conventional microbiological techniques. The prevalences of BDE in the control group, AMX group, CLI group, and MXF group were 96, 46, 85, and 57%, respectively, at 30 s; 64, 11, 70, and 24%, respectively, at 15 min; and 20, 4, 22, and 7%, respectively, at 1 h. Streptococcus spp. were the most frequently identified bacteria in all groups (44 to 68%), with the lowest percentage being detected in the AMX group (44%). AMX and MXF prophylaxis showed high efficacies in reducing the prevalence and duration of BDE, but CLI prophylaxis was noneffective. As a consequence, MXF prophylaxis is a promising antibiotic alternative for the prevention of BDE when beta-lactams are not indicated.

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confidence: 75%

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confidence: 99%

“…Moreover, increasing resistance to CLI among streptococci isolated from the bloodstream after dental extractions has been found (47); this could limit its use as a prophylactic drug.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Comparative Efficacies of Amoxicillin, Clindamycin, and Moxifloxacin in Prevention of Bacteremia following Dental Extractions

Dios

Tomás

Limeres

et al. 2006

Antimicrob Agents Chemother

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“…These facts are visible in the species of the viridans group of the genus Streptococcus, where the high resistance to macrolides (erythromycin, clarithromycin) 49 is frequently associated with high resistance to tetracyclines 50 and to clindamycin and azalides (azithromycin). 52 Considering that consumption of antibiotics in dentistry assumes 10% of the total consumption of antibiotics in the community, as mentioned above, it is possible to suspect a not unappreciable degree of responsibility in the selection of resistances due to antimicrobial treatments in dentistry. A high prevalence of oral iatrogenic bacteraemia has been described in our country caused by Streptococci resistant to erythromycin (40.8%) and clindamycin (21%), the majority of the isolates being sensitive to aminopenicillins.…”

Section: Antibiotics and Normal Floramentioning

confidence: 99%

Documento de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos dentales

Pérez¹,

Sebastián²,

Martínez³

et al. 2006

Av Odontoestomatol

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SUMMARYThe goal of antibiotic prophylaxis in Odontology is to prevent the onset of infections through the entrance way provided by the therapeutic action, therefore it is indicated provided there is a considerable risk of infection, either because of the characteristics of the operation itself or the patient's local or general condition. Nonetheless, clinical trials with antibiotics in dental pathologies scarcely adhere to the required methodological criteria and, in addition, are not sufficiently numerous. This text presents the results of an expert conference comprising the Presidents of the most representative Scientific Societies in Spain who have analyzed the existing literature and have drawn on their valuable professional experience. It describes the technical circumstances, analyzes the biological and pharmacological foundations and their application to the most representative medical situations. It is concluded that antibiotic prophylaxis in Odontology has certain well-founded, precise indications and offers the international scientific community a practical protocol for action.

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Clinical and microbiological efficacy of moxifloxacin versus amoxicillin/clavulanic acid in severe odontogenic abscesses: a pilot study

Al‐Nawas

Morbach

Seitner

et al. 2008

Eur J Clin Microbiol Infect Dis

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The aim of this study targeted the evaluation of the in vivo effect of moxifloxacin in the treatment of patients with severe odontogenic abscesses. This was a prospective, two-armed, randomised, unblinded, monocentric pilot study, which enrolled 21 hospitalized patients with severe odontogenic abscesses. After extraoral incision, patients were either treated with moxifloxacin 400 mg i.v. once daily or amoxicillin/clavulanic acid 2.2 g i.v. three times daily. Primary clinical endpoint was the time until clinical remission, represented by simultaneous assertion of the following criteria: body temperature <38.5 degrees C, no pain at palpation, and mouth opening similar or better than preoperatively. White blood cell count, C-reactive protein, pain, health related quality of life (HR-QoL) and length of hospital stay were recorded as secondary outcome criteria. The mean duration until reaching the primary end point was 6.6 (range, 4.3-8.8) days in the moxifloxacin group and 6.0 (range, 3.8-8.2) days in the amoxicillin/clavulanic acid group. Median days of in-house treatment ranged between five and six days for both groups. HR-QoL was highly impaired in both groups preoperatively and reached near normal on days three and four in both samples. In this pilot investigation, moxifloxacin showed promising results as compared to amoxicillin/clavulanic acid. Therefore, a larger prospective clinical trial using moxifloxacin in severe odontogenic abscesses appears encouraging. We suggest a combination of body temperature, palpatory pain, and subjective pain as a parameter for successful intervention; however, both findings need prospective validation by means of a phase III evaluation.

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In vitro activity of moxifloxacin compared to other antimicrobials against streptococci isolated from iatrogenic oral bacteremia in Spain

Cited by 27 publications

References 38 publications

Comparative Efficacies of Amoxicillin, Clindamycin, and Moxifloxacin in Prevention of Bacteremia following Dental Extractions

Comparative Efficacies of Amoxicillin, Clindamycin, and Moxifloxacin in Prevention of Bacteremia following Dental Extractions

Documento de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos dentales

Clinical and microbiological efficacy of moxifloxacin versus amoxicillin/clavulanic acid in severe odontogenic abscesses: a pilot study

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