Past administration of beta-lactam antibiotics and increase in the emergence of beta-lactamase-producing bacteria in patients with orofacial odontogenic infections.
OBJECTIVE
The purpose of this study was to determine the current status of beta-lactamase-producing bacteria in orofacial odontogenic infections.


METHODS
Microbiologic data regarding purulent exudate from 111 cases with orofacial odontogenic infections were analyzed in relation to the past administration of beta-lactams.


RESULTS
beta-lactamase-producing bacteria were isolated more frequently from the beta-lactam-administered group (38.5%) than from the beta-lactam-nonadministered group (10.9%; P <.005), and they were isolated more frequently as the duration of administration increased. The predominant bacteria isolated included Prevotella (the most frequent isolate), viridans streptococci, Peptostreptococcus, and Fusobacterium, and 7.1% of total isolates produced beta-lactamase. Penicillin and cefazolin worked well with beta-lactamase-nonproducing Prevotella but were remarkably affected by beta-lactamase-producing Prevotella. Cefmetazole, sulbactam/cefoperazone, and imipenem worked well against both types of Prevotella.


CONCLUSIONS
beta-lactams are still suitable for the first antimicrobial therapy in the treatment of these infections. However, because past beta-lactam administration increases the emergence of beta-lactamase-producing bacteria, beta-lactamase-stable antibiotics should be prescribed to patients with unresolved infections who have received beta-lactams.
Kuriyama
T
T
Department of Oral and Maxillofacial Surgery, School of Medicine. Kanazawa University, Kanazawa city, Ishikawa, Japan.
Nakagawa
K
K
Karasawa
T
T
Saiki
Y
Y
Yamamoto
E
E
Nakamura
S
S
D000038:Abscess / Q000188:drug therapy / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D000075202:Contraindications; D019557:Dermatitis, Perioral / Q000188:drug therapy / Q000382:microbiology*; D005491:Focal Infection, Dental / Q000188:drug therapy / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000201:enzymology*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010347:Patient Care Planning; D018440:beta-Lactam Resistance; D047090:beta-Lactams
D000900:Anti-Bacterial Agents; D047090:beta-Lactams