Severe versus local odontogenic bacterial infections: comparison of microbial isolates

• <i>Aim:</i> It was the aim of this study to evaluate the clinical and microbiological differences between severe and local odontogenic abscesses. <i>Methods:</i> Thirty patients were prospectively enrolled. Sixteen of 30 patients suffered from a severe life-threatening abscess of the head and neck, whereas 14/30 patients presented with a localized submucous abscess. Anaerobic bacteria were identified and susceptibility testing was performed using E test strips for penicillin, amoxicillin + clavulanic acid, imipenem + cilastatin, clindamycin and metronidazole. <i>Results:</i> The mean duration until removal of all drains was 14.1 and 3.5 days, respectively. Anaerobic bacteria were found in all episodes of local abscesses, whereas 19% of the severe episodes were culture negative, and in 13%, only aerobes were identified. A total of 60 anaerobes were isolated from 27 patients (2.2 isolates/positive sample). The dominating species were <i>Prevotella </i>sp. (n = 17), <i>Peptostreptococcus </i>sp. (n = 15) and <i>Propionibacterium </i>sp. (n = 5). Eighty-seven percent of the isolates were susceptible to penicillin. Ninety-seven percent of the anaerobes were susceptible to amoxicillin + clavulanic acid, imipenem + cilastatin, and clindamycin. Eighty-three percent were susceptible to metronidazol. There was a tendency for a higher rate of episodes with penicillin-resistant bacteria in the patients with severe abscesses (14 vs. 31%). No difference in susceptibility regarding amoxicillin + clavulanic acid and clindamycin (7%) was observed.

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