Antimicrobial choice of severe endodontic infection

다국어 초록 (Multilingual Abstract)

Objectives : The purpose of our study was to evaluate penicillin as a still drug of choice for severe endodontic infection, by analyzing the antimicrobial susceptibilities from endodontic infections with swelling to figure out appropriate antibiotics as empirical treatment.
Materials and methods : This study involved 18 patients who attended for emergency treatment because of facial or periapical swelling associated with root canal infections. Identification and antimicrobial susceptibility test of each pathogen were performed by Vitek2 Systems (bioMerieux, Marcy l’Etoile, France).
Results : The most frequent bacteria was Streptococcus spp.(77%), and the resistance against penicillin was 35% in overall patients, followed by clindamycin and erythromycin (17%), which was much higher than previous studies.
Conclusions : In our study, the higher resistance made penicillin alone not to be chosen as the first antibiotic drug for severe endodontic infections. Combinations with other drug, penicillin with wider spectrum of activity, or changing to other antibiotics was considered while remembering the increased risk of resistant microorganism.

목차 (Table of Contents)

• ABSTRACT
• Ⅰ. Introduction
• Ⅱ. Materials and methods
• Ⅲ. Results
• Ⅳ. Discussion
• 참고문헌

참고문헌 (Reference)

1 Ellison SJ., "The role of phenoxymethylpenicillin, amoxicillin, metronidazole and clindamycin in the management of acute dentoalveolar abscesses--a review" 206 (206): 357-362, 2009

2 Hawkey PM., "The growing burden of antimicrobial resistance" 62 (62): i1-i9, 2008

3 Skucaite N, "Susceptibility of endodontic pathogens to antibiotics in patients with symptomatic apical periodontitis" 36 (36): 1611-1616, 2010

4 Lewis MA, "Quantitative bacteriology of acute dento-alveolar abscesses" 21 (21): 101-104, 1986

5 Lewis MA, "Prevalence of penicillin resistant bacteria in acute suppurative oral infection" 35 (35): 785-791, 1995

6 Sundqvist G, "Prevalence of black-pigmented bacteroides species in root canal infections" 15 (15): 13-19, 1989

7 Heimdahl A, "Isolation of beta-lactamase-producing Bacteroides strains associated with clinical failures with penicillin treatment of human orofacial infections" 25 (25): 689-692, 1980

8 Khemaleelakul S, "Identification of bacteria in acute endodontic infections and their antimicrobial susceptibility" 94 (94): 746-755, 2002

9 Vigil GV, "Identification and antibiotic sensitivity of bacteria isolated from periapical lesions" 23 (23): 110-114, 1997

10 Poeschl PW, "Endodontic pathogens causing deep neck space infections : clinical impact of different sampling techniques and antibiotic susceptibility" 37 (37): 1201-1205, 2011

11 Henry M, "Effect of penicillin on postoperative endodontic pain and swelling in symptomatic necrotic teeth" 27 (27): 117-123, 2001

12 Sundqvist G., "Ecology of the root canal flora" 18 (18): 427-430, 1992

13 Ranta H, "Bacteriology of odontogenic apical periodontitis and effect of penicillin treatment" 20 (20): 187-192, 1988

14 Sandor GK, "Antimicrobial treatment options in the management of odontogenic infections" 64 (64): 508-514, 1998

15 Kuriyama T, "Antimicrobial susceptibility of 800 anaerobic isolates from patients with dentoalveolar infection to 13 oral antibiotics" 22 (22): 285-288, 2007

16 Pallasch TJ., "Antibiotics for acute orofacial infections" 21 (21): 34-44, 1993

17 Baumgartner JC, "Antibiotic susceptibility of bacteria associated with endodontic abscesses" 29 (29): 44-47, 2003

18 Baker PJ, "Antibiotic susceptibility of anaerobic bacteria from the human oral cavity" 64 (64): 1233-1244, 1985

19 Lewis MA, "Antibiotic susceptibilities of bacteria isolated from acute dentoalveolar abscesses" 23 (23): 69-77, 1989

20 Flynn TR, "Antibiotic selection in head and neck infections" 15 (15): 17-38, 2003

21 Gomes BP, "Analysis of the antimicrobial susceptibility of anaerobic bacteria isolated from endodontic infections in Brazil during a period of nine years" 37 (37): 1058-1062, 2011

22 Brook I, "Aerobic and anaerobic microbiology of periapical abscess" 6 (6): 123-125, 1991