Kannangara D W, Thadepalli H, McQuirter J L
Oral Surg Oral Med Oral Pathol. 1980 Aug;50(2):103-9. doi: 10.1016/0030-4220(80)90194-2.
The microbiologic and therapeutic aspects of sixty-one cases of pyogenic dental infection were studied through the use of modern anaerobic culture methods. Forty-five (74 percent) patients had anaerobic infections. Among them, eighteen (29.5 percent) had Bacteroides fragilis, of which six were resistant to penicillin at 16 microgram/ml. but all were susceptible to clindamycin at less than 2 microgram/ml. Of twenty-five patients treated with 4 to 20 million units of penicillin per day, twenty were cured and did not suffer relapse. The five patients in whom treatment failed had mandibular fractures infected with B. fragilis. Of ten patients treated with clindamycin (600 mg. intravenously every 6 hours), which included five patients with B. fragilis infections, all were cured. The presence of B. fragilis in dental infections has not been recognized. Dental infections associated with mandibular fracture that fail to respond to conventional penicillin therapy should be routinely cultured for B. fragilis.
通过使用现代厌氧培养方法，对61例化脓性牙感染的微生物学和治疗方面进行了研究。45例（74%）患者存在厌氧菌感染。其中，18例（29.5%）有脆弱拟杆菌感染，其中6例对16微克/毫升的青霉素耐药，但对低于2微克/毫升的克林霉素均敏感。在每天接受400万至2000万单位青霉素治疗的25例患者中，20例治愈且未复发。治疗失败的5例患者患有脆弱拟杆菌感染的下颌骨骨折。在接受克林霉素治疗的10例患者中（每6小时静脉注射600毫克），其中包括5例脆弱拟杆菌感染患者，全部治愈。牙感染中脆弱拟杆菌的存在尚未得到认识。对常规青霉素治疗无反应的与下颌骨骨折相关的牙感染，应常规培养脆弱拟杆菌。
