Mangundjaja S, Hardjawinata K
Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia.
Clin Ther. 1990 May-Jun;12(3):242-9.
The subjects were 106 patients, aged 14 to 70 years, with acute facial or oral abscesses originating from an odontogenic source. They were randomly assigned to receive 150 mg of clindamycin or 250 mg of ampicillin orally four times daily for seven days. After seven days of treatment, the infections were eradicated in 36 of the 52 clindamycin-treated patients and in 42 of the 54 ampicillin-treated patients, and improved in 16 and 11, respectively. One of the ampicillin group was a treatment failure. Mixed bacterial infections were found in most of the patients; 385 isolates were identified, 167 aerobes and 218 anaerobes. The most common aerobes were Staphylococcus aureus (in 58 patients), Staphylococcus epidermidis (in 47), and Staphylococcus viridans (in 32); the most common anaerobes were species of Peptococcus (in 76), Bacteroides (in 38), and Peptostreptococcus (in 33). No isolates were resistant to clindamycin; nine of 126 aerobes and six of 160 anaerobes were resistant to ampicillin. It is concluded that clindamycin is a safe and effective alternative antibiotic in the treatment of odontogenic infections.
研究对象为106例年龄在14至70岁之间、患有源自牙源性的急性面部或口腔脓肿的患者。他们被随机分配，分别接受每日4次、每次口服150毫克克林霉素或250毫克氨苄西林的治疗，疗程为7天。治疗7天后，52例接受克林霉素治疗的患者中有36例感染得到根除，54例接受氨苄西林治疗的患者中有42例感染得到根除，另有16例和11例患者的感染分别有所改善。氨苄西林组中有1例治疗失败。大多数患者存在混合细菌感染；共鉴定出385株分离菌，其中167株为需氧菌，218株为厌氧菌。最常见的需氧菌是金黄色葡萄球菌（58例患者中分离出）、表皮葡萄球菌（47例）和草绿色链球菌（32例）；最常见的厌氧菌是消化球菌属（76例）、拟杆菌属（38例）和消化链球菌属（33例）。没有分离菌对克林霉素耐药；126株需氧菌中有9株、160株厌氧菌中有6株对氨苄西林耐药。结论是，克林霉素是治疗牙源性感染的一种安全有效的替代抗生素。
