Volume 15, Number 4, December 2003
| | Sensitivity of Bacterial Isolates in Odontogenic Abscesses and Clinical Response to Clindamycin |
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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
Abstract
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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