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.
Highlights
Bacterial infections are the most common cause of purulent soft tissue inflammations in the head and neck area [1]. eir occurrence is favoured by a large variety of oral microbiota and lesions of dental tissues and the periodontium [2, 3]. e causes of infections are divided into odontogenic and nonodontogenic, with 70–90% of cases belonging to the first
Study and Control Groups and Patient Examination. e study included 52 patients, who were divided into two groups: (1) Study group (26 patients)—patients who were diagnosed with the following: (a) Submucous abscess, requiring removal of causative teeth, as well as soft tissue incision and setoning—2 women and 13 men (b) Periapical abscess, requiring only removal of causative teeth—3 women and 8 men
According to the EUCAST 8.1 guidelines, in the case of infections caused by anaerobic bacteria, gentamicin, biseptol, cefuroxime, ciprofloxacin, cefepime, and ampicillin are not recommended
Summary
Bacterial infections are the most common cause of purulent soft tissue inflammations in the head and neck area [1]. eir occurrence is favoured by a large variety of oral microbiota and lesions of dental tissues and the periodontium [2, 3]. e causes of infections are divided into odontogenic and nonodontogenic, with 70–90% of cases belonging to the firstBioMed Research International group. e most common odontogenic causes are gangrenous teeth, complicated third molar eruption, infected dental cysts, residual tooth roots, and complications after endodontic treatment [4,5,6]. e most frequent cause of the development of periapical inflammatory changes is pulpitis, which results from negligence in conservative treatment [7, 8]. e bacterial antigens present in the inflamed pulp tissue stimulate the specific and nonspecific immune responses of the body, but it is usually not possible to completely eradicate the infection [9]. Bacterial infections are the most common cause of purulent soft tissue inflammations in the head and neck area [1]. A chronic inflammatory change develops in the periapical region of the infected tooth. Chronic inflammations are usually asymptomatic and almost always lead to bone resorption around the tooth root, giving characteristic lucencies in the X-ray image. Acute inflammations do not show any characteristic features in the X-ray image. In some cases, they can manifest themselves in the widening of the periodontal ligament space [11]. Acute inflammation can be both a primary condition and exacerbation of chronic inflammation It is characterized by a fast course, during which there is no natural barrier to the spread of infection
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