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莫西沙星与克林霉素/头孢曲松在牙源性颌面感染性疾病治疗中的对比:一项初步的、医院内对照临床试验

Moxifloxacin versus Clindamycin/Ceftriaxone in the management of odontogenic maxillofacial infectious processes: A preliminary, intrahospital, controlled clinical trial.

作者信息

Gómez-Arámbula Hansel, Hidalgo-Hurtado Antonio, Rodríguez-Flores Rosaura, González-Amaro Ana-María, Garrocho-Rangel Arturo, Pozos-Guillén Amaury

机构信息

DDS, Resident, Department of Orofacial Surgery; Hospital "Ignacio Morones Prieto", San Luis Potosi, SLP, Mexico.

DDS, Associate Professor, Department of Orofacial Surgery; Hospital "Ignacio Morones Prieto", San Luis Potosi, SLP, Mexico.

出版信息

J Clin Exp Dent. 2015 Dec 1;7(5):e634-9. doi: 10.4317/jced.52627. eCollection 2015 Dec.

Abstract

BACKGROUND

The aim of this study was to compare the days of hospitalization length between patients treated with Moxifloxacin with that of patients treated with a Clindamycin/Ceftriaxone combination and additionally, to isolate and identify the oral pathogens involved in orofacial odontogenic infections.

MATERIAL AND METHODS

A pilot-controlled-clinical-trial was carried out on hospitalized patients with cervicofacial odontogenic abscesses or cellulitis, who were randomly asigned to two study groups: 1) patients who received Moxifloxacin, and 2) patients receiving Clindamycin/Ceftriaxone combination. Infiltrate samples were collected through transdermic or transmucosal punction and later cultured on a media specific for aerobic and anaerobic microorganisms. Mean hospitalization duration in days until hospital discharge and susceptibility assessment in rates were established.

RESULTS

Mean hospitalization time in days of patients treated with Moxifloxacin was 7.0 ± 1.6 days, while in the Clindamycin/Ceftriaxone group, this was 8.4 ± 1.8 days, although significant difference could not be demonstrated (p=0.074). A total of 43 strains were isolated, all of these Gram-positive. These strains appeared to be highly sensitive to Moxifloxacin (97.5%) and Ceftriaxone (92.5%).

CONCLUSIONS

Moxifloxacin and Ceftriaxone appear to be potential convenient and rational alternatives to traditional antibiotics, for treating severe odontogenic infections, in conjunction with surgical extraoral incision, debridement, and drainage.

KEY WORDS

Orofacial odontogenic infections, antimicrobial susceptibility, antimicrobial resistance.

摘要

背景

本研究旨在比较接受莫西沙星治疗的患者与接受克林霉素/头孢曲松联合治疗的患者的住院天数,并另外分离和鉴定口腔颌面部牙源性感染中涉及的口腔病原体。

材料与方法

对患有颌面部牙源性脓肿或蜂窝织炎的住院患者进行了一项试点对照临床试验,这些患者被随机分配到两个研究组:1)接受莫西沙星的患者,以及2)接受克林霉素/头孢曲松联合治疗的患者。通过经皮或经粘膜穿刺采集浸润样本,随后在针对需氧和厌氧微生物的特定培养基上进行培养。确定了直至出院的平均住院天数和感染率的药敏评估。

结果

接受莫西沙星治疗的患者的平均住院天数为7.0±1.6天,而在克林霉素/头孢曲松组中,这一数字为8.4±1.8天,尽管未显示出显著差异(p=0.074)。共分离出43株菌株,所有这些菌株均为革兰氏阳性。这些菌株似乎对莫西沙星(97.5%)和头孢曲松(92.5%)高度敏感。

结论

莫西沙星和头孢曲松似乎是治疗严重牙源性感染的传统抗生素的潜在方便且合理的替代品,可结合外科口腔外切开、清创和引流使用。

关键词

口腔颌面部牙源性感染;抗菌药敏性;抗菌耐药性

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc77/4663067/32feba6ec4c3/jced-7-e634-g001.jpg

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