Volume 15, Number 4, December 2003

Sensitivity of Bacterial Isolates in Odontogenic Abscesses and Clinical Response to Clindamycin

Karlina Hardjawinata,1 Sunardi Mangundjaja,2 Ken Rani Sartono1

1Department of Oral Biology and 2Department of Oral Surgery, Faculty of Dentistry Padjadjaran University, Bandung, Indonesia

Objective: To analyse the sensitivity of bacterial isolates in odontogenic abscesses and the clinical response to clindamycin.
Patients and Methods: 150 adult patients with odontogenic infections for less than 1 week, requiring surgery, antibiotic therapy, and yielding pus on aspiration were enrolled in a microbiological and clinical study. Patients were treated with 150 mg of clindamycin 4 times daily. The effect of clindamycin was evaluated according to the absence or presence of pus in the abscess after 7 days of treatment plus white blood cell count, blood pressure, and body temperature. Pus samples were inoculated on brain-heart infusion agar in aerobic incubation, and Schaedler agar in anaerobic incubation. The isolated bacteria were identified based on growth characteristics, colonial morphology, Gram's stain reactions, and biochemical assays. Using a disk-diffusion method, the antimicrobial susceptibility of the isolates was determined. According to the rapid iodometric slide test method, β-lactamase production was assayed.
Results: All patients had more than 1 microorganism isolated from their abscess. A total of 426 isolates were identified — 181 isolates were aerobes and 245 were anaerobes. The most common aerobes were
Staphylococcus aureus (75.3%), the viridans-group of Streptococcus (42.7%), and Streptococcus haemolyticus (2.7%). The most common anaerobes found were Peptococcus species (55.3%), gram-positive rods (46.0%), Peptostreptococcus species (34.0%), and gram-negative rods (24.7%). Of the 113 strains of Staphylococcus aureus isolated, all were sensitive to clindamycin. All microorganisms were β-lactamase-negative. There were no clinically significant changes in blood pressure, white blood cell count, or body temperature after the treatment.
Conclusion: Clindamycin can be considered a good choice of antibiotic and is bacteriologically and clinically effective for treating odontogenic infections.

Key words:
Abscess, Bacterial infection, Beta-lactamase, Clindamycin, Microorganisms

Asian J Oral Maxillofac Surg. 2003;15:250-255.

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