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牙源性感染的治疗:两种抗生素治疗方案的分析

Treatment of odontogenic infections: An analysis of two antibiotic regimens.

作者信息

Bhagania Manish, Youseff Wael, Mehra Pushkar, Figueroa Ruben

机构信息

Department of Oral and Maxillofacial Surgery, Boston University, Boston, MA, USA.

Private Practice in Oral and Maxillofacial Surgery, Milford, MA, USA.

出版信息

J Oral Biol Craniofac Res. 2018 May-Aug;8(2):78-81. doi: 10.1016/j.jobcr.2018.04.006. Epub 2018 Apr 23.

Abstract

PURPOSE

Retrospective analysis of the efficacy for two commonly used antibiotic regimens in the management of severe odontogenic infections.

PATIENTS AND METHODS

Evaluation of records of patients admitted to the Oral and Maxillofacial Surgery service at Boston University Medical Center from 2009 to 2014 with severe infections of odontogenic origin (SOI). Patients were divided into two groups based on the administered intravenous antibiotic: 1) Group I: Clindamycin only and 2) Group II: Penicillin and Metronidazole. Variables evaluated included demographic characteristics, ASA status, and anatomic site of infection risk, length of hospital stay, antibiotic failure, and pharmaceutical treatment cost.

RESULTS

78 patients (46 males and 32 females) were included in the study. There were 57 patients in group I (average age 32.6 years) and 21 in Group II (average age 32.8 years). The average white cell count at time of admission count was higher in Group I (19.3) versus Group II (17.4). Antibiotic failure rate was 3.5% in Group I and 4.7% for group 2 patients.

CONCLUSION

Clindamycin alone and combination of Penicillin with Metronidazole are both effective pharmaceutical regimens for SOI. Clindamycin therapy resulted in shorter hospital stay and lower net treatment costs with a slightly higher success rate.

摘要

目的

回顾性分析两种常用抗生素方案治疗严重牙源性感染的疗效。

患者与方法

对2009年至2014年入住波士顿大学医学中心口腔颌面外科、患有严重牙源性感染(SOI)的患者记录进行评估。根据静脉使用的抗生素将患者分为两组:1)第一组:仅使用克林霉素;2)第二组:青霉素和甲硝唑。评估的变量包括人口统计学特征、美国麻醉医师协会(ASA)分级、感染风险的解剖部位、住院时间、抗生素治疗失败情况以及药物治疗费用。

结果

78例患者(46例男性和32例女性)纳入研究。第一组有57例患者(平均年龄32.6岁),第二组有21例患者(平均年龄32.8岁)。第一组入院时的平均白细胞计数(19.3)高于第二组(17.4)。第一组的抗生素治疗失败率为3.5%,第二组患者为4.7%。

结论

单独使用克林霉素以及青霉素与甲硝唑联合使用都是治疗严重牙源性感染的有效药物方案。克林霉素治疗可缩短住院时间,降低净治疗成本,成功率略高。

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