Xiao Wei-Xiong, Yang Xi, Wang Min
Department of Stomatology, Wangjiang Hospital, Sichuan University Chengdu 610065, Sichuan, China.
Department of Stomatology, Stomatological Hospital of Chongqing Medical University Chongqing 400015, China.
Am J Transl Res. 2024 Jul 15;16(7):2814-2827. doi: 10.62347/ICYR9713. eCollection 2024.
To assess the efficacy of targeted therapy based on drug sensitivity testing (DST) results in patients with acute pulpitis (AP).
A total of 80 cases of AP were included retrospectively and divided into two groups: control (Ctrl) group (conventional drug palliative therapy, n=40) and experimental (Exp) group (DST + non-resistant drugs, n=40). The clinical data and laboratory examination data of patients, including bacterial culture data, drug sensitivity test results, Ca and P contents in dental pulp, visual analogue scale (AVS), treatment satisfaction, and dental pulp incidence, were collected and analyzed.
, , and exhibited higher resistance rates (RS) to penicillin and amoxicillin but no resistance to imipenem and metronidazole. The content of Ca and P in the dental pulp of the Exp group patients was significantly higher than that of the Ctrl group (=0.006). The total response rate (95% vs. 77.5%, =0.018) and overall patient satisfaction (92.5% vs. 80%, =0.021) were also significantly higher in the Exp group than in the Ctrl group. Additionally, when the follow-up duration exceeded 1 year, the incidence of dental pulp reactions in the Exp group was significantly lower than that of the Ctrl group (=0.026).
These findings suggest that Gram-negative anaerobes are the predominant oral pathogens in patients with AP. Imipenem and metronidazole demonstrate the most effective anti-infective properties against these anaerobes. Utilizing DST to select non-resistant drugs for treatment prior to therapy effectively enhances clinical outcomes for patients with AP.
评估基于药物敏感性试验(DST)结果的靶向治疗对急性牙髓炎(AP)患者的疗效。
回顾性纳入80例AP患者,分为两组:对照组(Ctrl组,采用传统药物姑息治疗,n = 40)和试验组(Exp组,采用DST + 非耐药药物,n = 40)。收集并分析患者的临床资料和实验室检查数据,包括细菌培养数据、药物敏感性试验结果、牙髓中钙和磷的含量、视觉模拟评分(AVS)、治疗满意度以及牙髓发病率。
[具体细菌名称]对青霉素和阿莫西林表现出较高的耐药率(RS),但对亚胺培南和甲硝唑无耐药性。Exp组患者牙髓中钙和磷的含量显著高于Ctrl组(P = 0.006)。Exp组的总有效率(95% vs. 77.5%,P = 0.018)和患者总体满意度(92.5% vs. 80%,P = 0.021)也显著高于Ctrl组。此外,随访时间超过1年时,Exp组牙髓反应的发生率显著低于Ctrl组(P = 0.026)。
这些发现表明革兰氏阴性厌氧菌是AP患者的主要口腔病原体。亚胺培南和甲硝唑对这些厌氧菌表现出最有效的抗感染特性。在治疗前利用DST选择非耐药药物进行治疗可有效提高AP患者的临床疗效。