title: Antimicrobial susceptibility of major pathogens of orofacial odontogenic infections to 11 beta-lactam antibiotics.
abstract: In this study, we evaluated the current effectiveness of 11 beta-lactam antibiotics for treatment of orofacial odontogenic infections by determining the antimicrobial susceptibility of the major pathogens. The antimicrobial susceptibilities of viridans streptococci (n = 47), Peptostreptococcus (n = 67), Porphyromonas (n = 18), Fusobacterium (n = 57), black-pigmented Prevotella (n = 59) and non-pigmented Prevotella (n = 47) isolated from pus specimens of 93 orofacial odontogenic infections to penicillin G, cefmetazole, flomoxef, cefoperazone, cefoperazone/sulbactam, ceftazidime, cefpirome, cefepime, cefoselis, imipenem and faropenem were determined using the agar dilution method. Penicillin G, most cephalosporins, imipenem and faropenem worked well against viridans streptococci, Peptostreptococcus, Porphyromonas and Fusobacterium. Penicillin G and most cephalosporins, including fourth-generation agents, were not effective against beta-lactamase-positive Prevotella, though they were effective against beta-lactamase-negative strains. Cefmetazole, cefoperazone/sulbactam, imipenem and faropenem expressed powerful antimicrobial activity against beta-lactamase-positive Prevotella. In conclusion, penicillins have the potential to be first-line agents in the treatment of orofacial odontogenic infections. Most of the other beta-lactam antibiotics, including fourth-generation cephalosporins, were not found to have greater effectiveness than penicillins. In contrast, cefmetazole, cefoperazone/sulbactam, imipenem and faropenem were found to have greater effectiveness than penicillins.
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000188:drug therapy*; D016866:Bacteroidaceae Infections / Q000188:drug therapy; D000077723:Cefepime; D015311:Cefmetazole / Q000627:therapeutic use; D002438:Cefoperazone / Q000008:administration & dosage / Q000627:therapeutic use; D002442:Ceftazidime / Q000627:therapeutic use; D015296:Ceftizoxime / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005673:Fusobacterium / Q000187:drug effects; D005674:Fusobacterium Infections / Q000188:drug therapy; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007769:Lactams; D008826:Microbial Sensitivity Tests; D009059:Mouth Diseases / Q000188:drug therapy / Q000382:microbiology*; D010400:Penicillin G / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D010462:Peptostreptococcus / Q000187:drug effects; D016966:Porphyromonas gingivalis / Q000187:drug effects; D018720:Prevotella / Q000187:drug effects; D013290:Streptococcal Infections / Q000188:drug therapy; D013291:Streptococcus / Q000187:drug effects; D013407:Sulbactam / Q000008:administration & dosage / Q000627:therapeutic use; D047090:beta-Lactams; D000097572:Cefpirome
chemical_list: D000900:Anti-Bacterial Agents; D000077723:Cefepime; D015311:Cefmetazole; D002438:Cefoperazone; D002442:Ceftazidime; D015296:Ceftizoxime; D002511:Cephalosporins; D015378:Imipenem; D007769:Lactams; D010400:Penicillin G; D010406:Penicillins; D013407:Sulbactam; D047090:beta-Lactams; D000097572:Cefpirome; C079769:cefoselis; C107057:fropenem; C045693:flomoxef