Gheibollahi Hamed, Mousavi Sona, Daneste Hossein, Taheri Mohammad Mehdi, Peyravi Ali, Babaei Amirhossein
1. Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
2. Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Rajaei Acute Care Surgical Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Otolaryngol Pol. 2023 Feb 3;77(2):1-5.
Odontogenic infections are polymicrobial in origin and can be life-threatening. Antibacterial failure is an important issue in the treatment of odontogenic infections. This study aimed to determine the factors associated with antibacterial failure in patients with head and neck infections with odontogenic sources.
This retrospective epidemiological study was performed using data collected from 229 patients with head and neck infections with an odontogenic source who had been operated on in Shahid Rajaee hospital from March 2014 to December 2019.
123 (53.7%) patients were female and there were106 (46.3%) males. The mean age ± SD was 33.01±13.37 years (range 7 to 80). The most common offending teeth were lower molars (81.7%) and lower premolars (5.7%). The most common site of infection was the submandibular area (36.4%) followed by the buccal (20.4%) and pterygomandibular (17.1%) regions. The most common pathogen was Streptococcus haemolyticus. The length of hospitalization was higher (4.66 days) in patients with failure of treatment compared to those without it (6.00 days) (p=0.002). A combination of penicillin G and metronidazole was prescribed for all patients with failure of treatment compared with 57.6% in patients without failure of treatment (p=0.002). There was no statistically significant difference between the two groups regarding age, duration of illness before hospitalization, WBC, gender and history of chemotherapy, hypertension, smoking, pregnancy, alcohol usage, diabetes mellitus, the rate of fever, trismus, dysphagia, malaise, antibiotic before hospitalization, and surgical approach.
Possible determinants in this study were not associated with antibacterial failure. Further studies should be conducted to investigate this relationship.
牙源性感染起源于多种微生物，可能危及生命。抗菌治疗失败是牙源性感染治疗中的一个重要问题。本研究旨在确定头颈部牙源性感染患者抗菌治疗失败的相关因素。
本回顾性流行病学研究使用了2014年3月至2019年12月在沙希德拉贾伊医院接受手术的229名头颈部牙源性感染患者的收集数据。
123名（53.7%）患者为女性，106名（46.3%）为男性。平均年龄±标准差为33.01±13.37岁（范围7至80岁）。最常引发问题的牙齿是下颌磨牙（81.7%）和下颌前磨牙（5.7%）。最常见的感染部位是下颌下区（36.4%），其次是颊部（20.4%）和翼下颌区（17.1%）。最常见的病原体是溶血性链球菌。治疗失败患者的住院时间较长（4.66天），而未治疗失败患者的住院时间为6.00天（p=0.002）。所有治疗失败的患者都使用了青霉素G和甲硝唑联合治疗，而未治疗失败的患者中这一比例为57.6%（p=0.002）。两组在年龄、住院前病程、白细胞、性别、化疗史、高血压、吸烟、妊娠、饮酒、糖尿病、发热率、牙关紧闭、吞咽困难、不适、住院前使用抗生素以及手术方式等方面没有统计学上的显著差异。
本研究中的可能决定因素与抗菌治疗失败无关。应进行进一步研究以调查这种关系。
