Brescó-Salinas Miguel, Costa-Riu Noelia, Berini-Aytés Leonardo, Gay-Escoda Cosme
Barcelona University Dental School, Barcelona, Spain.
Med Oral Patol Oral Cir Bucal. 2006 Jan 1;11(1):E70-5.
An evaluation is made of bacterial species and susceptibility to various antibiotics used in application to odontogenic infections of periapical location and in pericoronitis of the lower third molar, with the aim of optimizing the antibiotherapy of such infections and thus preventing unnecessary side effects and over-treatment.
Sixty-four patients with odontogenic infection were selected on the basis of a series of inclusion and exclusion criteria. Samples were collected from lesions under maximally aseptic conditions, avoiding oral saprophytic contamination. The samples were cultured and incubated under aerobic and anaerobic conditions, followed by bacteriological identification and antibiotic susceptibility testing.
A total of 184 bacterial strains were isolated and identified, comprising grampositive facultative anaerobes (68%), gramnegative strict anaerobes (30%) and grampositive facultative anaerobes (2%). Regardless of the origin of the odontogenic infection, the causal bacteria yielded the best results in terms of increased sensitivity and lesser resistance with amoxicillin / clavulanate and amoxicillin, respectively (p<0.05).
There are increasingly numerous reports in the literature of growing bacterial resistance to antibiotics in infectious processes affecting non-buccodental territories. This same tendency has not been observed in relation to oral infections, though important resistance has been documented for certain concrete antibiotics. According to our results, the common-use antibiotics with the greatest sensitivity and lowest resistance were shown to be amoxicillin/clavulanate followed by amoxicillin alone.
对用于根尖周牙源性感染及下颌第三磨牙冠周炎的各种抗生素的细菌种类及敏感性进行评估,以优化此类感染的抗生素治疗,从而预防不必要的副作用和过度治疗。
根据一系列纳入和排除标准选取64例牙源性感染患者。在最大无菌条件下从病变处采集样本,避免口腔腐生菌污染。样本在需氧和厌氧条件下培养及孵育,随后进行细菌学鉴定和抗生素敏感性测试。
共分离并鉴定出184株细菌,包括革兰氏阳性兼性厌氧菌(68%)、革兰氏阴性严格厌氧菌(30%)和革兰氏阳性兼性厌氧菌(2%)。无论牙源性感染的来源如何,致病细菌分别对阿莫西林/克拉维酸盐和阿莫西林的敏感性增加及耐药性降低方面产生了最佳结果(p<0.05)。
在影响非口腔牙领域的感染过程中,文献中关于细菌对抗生素耐药性增加的报道越来越多。在口腔感染方面未观察到相同趋势,尽管已记录到某些具体抗生素存在重要耐药性。根据我们的结果,显示出敏感性最高和耐药性最低的常用抗生素是阿莫西林/克拉维酸盐,其次是单独的阿莫西林。