Rao Dipesh D, Desai Anilkumar, Kulkarni R D, Gopalkrishnan K, Rao C Bhasker
Department of Oral and Maxillofacial Surgery, S.D.M College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Oct;110(4):e7-12. doi: 10.1016/j.tripleo.2010.04.016. Epub 2010 Jul 24.
Orofacial space infections are common presentations in maxillofacial clinics even in the post-antibiotic era. One of the main factors determining the spread of infection is the host defense mechanism. Diabetes is one of the most common systemic illness suppressing the immunity of an individual and increasing their susceptibility to infections. This study was carried out to compare the spaces involved, the severity of infection, the virulent organism, the efficacy of empirical antibiotics, the length of hospital stay, and the complications encountered in the management of maxillofacial space infection of odontogenic origin in diabetic patients as compared with nondiabetic patients.
A 4-year prospective study was carried out on patients with maxillofacial space infection of odontogenic origin. The patients were divided into 2 groups on the basis of presence or absence of diabetes.
A total of 111 patients were identified out of which 31 were diabetic. The organisms commonly isolated were Streptococcus species with submandibular space being the most common space involved in both the groups. The empirical antibiotic used was amoxicillin plus clavulanic acid combined with metrogyl in 70.27% cases.
Streptococcus species is still the most common causative pathogen irrespective of the diabetic status of the patient. The same empirical antibiotic therapy of amoxicillin plus clavulanic acid combined with metrogyl along with hyperglycemia control and surgical drainage of infection yielded satisfactory resolution of infection in the diabetic patients as well.
即使在抗生素时代之后,口腔颌面部间隙感染仍是口腔颌面诊所常见的病症。决定感染扩散的主要因素之一是宿主防御机制。糖尿病是最常见的抑制个体免疫力并增加其感染易感性的全身性疾病之一。本研究旨在比较糖尿病患者与非糖尿病患者在牙源性口腔颌面部间隙感染的治疗中所涉及的间隙、感染严重程度、致病微生物、经验性抗生素的疗效、住院时间以及并发症。
对牙源性口腔颌面部间隙感染患者进行了为期4年的前瞻性研究。根据是否患有糖尿病将患者分为两组。
共确定了111例患者,其中31例为糖尿病患者。常见分离出的微生物为链球菌属,两组中最常受累的间隙均为下颌下间隙。70.27%的病例使用的经验性抗生素为阿莫西林加克拉维酸联合甲硝唑。
无论患者的糖尿病状态如何,链球菌属仍然是最常见的致病病原体。对于糖尿病患者,同样采用阿莫西林加克拉维酸联合甲硝唑的经验性抗生素治疗,同时控制高血糖并进行感染的手术引流,也能使感染得到满意的缓解。