Department for Oral and Cranio-Maxillo and Facial Plastic Surgery, (Head: Prof. Dr. Dr. Rudolf H. Reich), University of Bonn, Germany.
J Craniomaxillofac Surg. 2017 Oct;45(10):1731-1735. doi: 10.1016/j.jcms.2017.07.013. Epub 2017 Jul 28.
The microbial flora of infections of the orofacial region of odontogenic origin is typically polymicrobial. Shortly after mass production of the first antibiotics, antibiotic resistant microorganisms were observed.
A 28-months retrospective study evaluated hospital records of 107 patients that were treated for head and neck infections of odontogenic origin. All patients underwent surgical incision and drainage.
There were 65 male (61%) and 42 female (39%) patients ranging in age from 5 to 91 years, with a mean age of 48 years (SD = 21). 52 patients underwent outpatient management and 55 patients inpatient management. A total of 92 bacterial strains were isolated from 107 patients, accounting for 0.86 isolates per patient. Overall 46 bacterial strains were isolated from patients that underwent outpatient and 34 bacterial strains that underwent inpatient treatment. 32.6% of the strains, isolated from outpatient treated individuals showed resistances against one or more of the tested antibiotics. Isolated strains of inpatient treated individuals showed resistances in 52.9%.
According to this study's data, penicillin continues to be a highly effective antibiotic to be used against viridans streptococci, group C Streptococci and prevotella, whereas clindamycin was not shown to be effective as an empirical drug of choice for most odontogenic infections.
Microorganisms that show low susceptibility to one or more of the standard antibiotic therapy regimes have a significantly higher chance of causing serious health problems, a tendency of spreading and are more likely to require an inpatient management with admission of IV antibiotics. Penicillin continues to be a highly effective antibiotic to be used against viridans streptococci, group C Streptococci and prevotella, whereas clindamycin could not be shown to be effective as an empirical drug of choice for a high number of odontogenic infections.
源自牙源性的口颌面区域感染的微生物菌群通常为多种微生物共存。在第一批抗生素大规模生产后不久，就观察到了对抗生素有耐药性的微生物。
一项为期 28 个月的回顾性研究，评估了 107 例因牙源性头颈部感染而接受治疗的患者的医院记录。所有患者均接受了手术切开引流。
65 例男性（61%）和 42 例女性（39%）患者年龄在 5 至 91 岁之间，平均年龄为 48 岁（SD=21）。52 例患者接受门诊治疗，55 例患者接受住院治疗。从 107 例患者中总共分离出 92 株细菌，每位患者平均分离出 0.86 株细菌。从接受门诊治疗的患者中总共分离出 46 株细菌，从接受住院治疗的患者中分离出 34 株细菌。在门诊治疗的患者中，32.6%的分离菌株对一种或多种测试抗生素有耐药性。住院治疗的患者中分离出的菌株有 52.9%表现出耐药性。
根据本研究的数据，青霉素仍然是一种对抗草绿色链球菌、C 群链球菌和普雷沃菌非常有效的抗生素，而克林霉素作为大多数牙源性感染的经验性首选药物并不有效。
对一种或多种标准抗生素治疗方案表现出低敏感性的微生物更有可能导致严重的健康问题，更有可能传播，并更有可能需要住院治疗，静脉注射抗生素。青霉素仍然是一种对抗草绿色链球菌、C 群链球菌和普雷沃菌非常有效的抗生素，而克林霉素不能被证明是许多牙源性感染的有效经验性首选药物。
