Universität zu Köln

Zirk, Matthias, Buller, Johannes, Goeddertz, Peter, Rothamel, Daniel, Dreiseidler, Timo, Zoeller, Joachim E. and Kreppel, Matthias (2016). Empiric systemic antibiotics for hospitalized patients with severe odontogenic infections. J. Cranio-MaxilloFac. Surg., 44 (8). S. 1081 - 1089. EDINBURGH: CHURCHILL LIVINGSTONE. ISSN 1878-4119

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Abstract

Introduction: Odontogenic infections may lead to severe head and neck infections with potentially great health risk. Age, location of purulent affected sites and beta-lactam allergy are some mentionable factors regarding patients' in-hospital stay and course of disease. Are there new challenges regarding bacteria' antibiotic resistance for empiric treatment and what influences do they have on patients' clinical course? Methods: We analyzed in a 4-year retrospective study the medical records of 294 in-hospital patients with severe odontogenic infections. On a routine base bacteria were identified and susceptibility testing was performed. Length of stay in-hospital was evaluated regarding patients' age, beta-lactam allergy profile, affected sites and bacteria susceptibility to empiric antibiotics. Results: Length of stay in-hospital was detected to be associated with affected space and penicillin allergy as well (p < 0.05). Isolates presented large amounts of aerobic gram-positive bacteria (64.2%), followed by facultative anaerobic bacteria (gram+/15.8%, gram-/12.7%). Tested ampicillin in combination with sulbactam (or without) and cephalosporins displayed high susceptibility rates, revealing distinguished results regarding clindamycin (p < 0.05). Co-trimoxazol and moxifloxacin showed high overall susceptibility rates (MOX: 94.7%, COTRIM: 92.6%). Discussion: This study demonstrates ampicillin/sulbactam in addition to surgical intervention is a good standard in treatment of severe odontogenic neck infections. Cephalosporins seem to be a considerable option as well. If beta-lactam allergy is diagnosed co-trimoxazol and moxifloxacin represent relevant alternatives. Conclusion: Age, allergic profile and bacteria' resistance patterns for empiric antibiotics have an influence on patients in-hospital stay. Ampicillin/sulbactam proves itself to be good for empiric antibiosis in severe odontogenic infections. Furthermore cephalosporins could be considered as another option in treatment. However moxifloxacin and co-trimoxazol deserves further investigation as empiric antibiosis in odontogenic infections if beta-lactam allergy is diagnosed. (C) 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zirk, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Buller, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Goeddertz, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Rothamel, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Dreiseidler, Timo UNSPECIFIED UNSPECIFIED UNSPECIFIED Zoeller, Joachim E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreppel, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-268915
DOI:	10.1016/j.jcms.2016.05.019
Journal or Publication Title:	J. Cranio-MaxilloFac. Surg.
Volume:	44
Number:	8
Page Range:	S. 1081 - 1089
Date:	2016
Publisher:	CHURCHILL LIVINGSTONE
Place of Publication:	EDINBURGH
ISSN:	1878-4119
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEEP NECK INFECTION; OF-THE-LITERATURE; MAXILLOFACIAL INFECTIONS; PENICILLIN ALLERGY; ANAEROBIC-BACTERIA; SPACE INFECTIONS; ABSCESSES; MANAGEMENT; ORIGIN; IMPACT Multiple languages Dentistry, Oral Surgery & Medicine; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26891