Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne, Kerpener Strasse 62, 50931, Cologne, Germany.
Department of Dermatology, University of Cologne, Cologne, Germany.
Clin Oral Investig. 2021 Feb;25(2):563-570. doi: 10.1007/s00784-020-03492-1. Epub 2020 Aug 10.
Odontogenic infections descending from the lower jaw may lead to severe health conditions. Commonly, a biphasic treatment of surgical drainage and antibiotic therapy is conducted. The choice of the administered empiric antibiotic agent remains debatable.
Retrospectively, we analyzed 350 medical records of patients who were consecutively treated with odontogenic infections descending from the lower jaw. All patients received surgical drainage and either cefazolin or ampicillin/sulbactam as empiric antibiosis. In particular, the number of secondary operations, infectious parameters, and length of in-hospital stay were investigated.
The most frequently infected space was the perimandibular/buccal space for both groups followed by the submandibular space. Number of revision procedures, early recurrence, and length of stay presented no significant difference between both groups (p > 0.05). Inflammatory parameters (c-reactive protein, leukocytes) similarly decreased in both groups.
Cefazolin targets the majority of the pathogens detected in severe odontogenic neck infections descending from the lower jaw and reveals comparable results to AMP/S in regard to the inflammatory parameters and in-hospital stay.
Cefazolin is a feasible empiric antibiosis for odontogenic neck infections descending from the lower jaw if surgical drainage is performed.
下颌源性感染可能导致严重的健康问题。通常,采用手术引流和抗生素治疗的两阶段方法进行治疗。所使用的经验性抗生素的选择仍存在争议。
我们回顾性分析了连续接受下颌源性感染治疗的 350 例患者的病历。所有患者均接受手术引流和头孢唑林或氨苄西林/舒巴坦作为经验性抗生素治疗。特别调查了二次手术的数量、感染参数和住院时间。
两组中最常感染的部位是下颌/颊间隙,其次是下颌下间隙。两组之间的手术次数、早期复发和住院时间均无显著差异(p>0.05)。两组的炎症参数(C 反应蛋白、白细胞)均相似下降。
头孢唑林针对下颌源性严重颈部感染中检测到的大多数病原体,在炎症参数和住院时间方面与 AMP/S 相比具有相当的结果。
如果进行手术引流,头孢唑林是下颌源性颈部感染的一种可行的经验性抗生素。