title: In vitro killing activity of crevicular concentrations of tinidazole plus common oral antibiotics against high-density mixed inocula of periodontal pathogens in strict anaerobic conditions.
abstract: BACKGROUND
  Odontogenic infections are polymicrobial. This study explores the in vitro killing activity by concentrations similar to those found in crevicular fluid of tinidazole in combination with amoxicillin/clavulanic acid, clindamycin and levofloxacin against four groups of high-density mixed inocula of anaerobes (Prevotella buccae, Fusobacterium nucleatum, and Veillonella spp.) and facultative (Capnocytophaga spp. and Streptococcus spp.) isolates of periodontal pathogens.
  
  
  METHODS
  Killing curves were assessed under strict anaerobic conditions with antibiotics alone and in combination with tinidazole at concentrations similar to those achieved in crevicular fluid against approximately 10(7) colony forming units (CFU)/ml inoculum (1:1:1:1:1 proportion of the five bacterial isolates) of the four bacterial groups. Group 1 did not include beta-lactamase-producing strains; groups 2, 3, and 4 included one, two, and three beta-lactamase-producing strains, respectively.
  
  
  RESULTS
  In single-drug experiments, at 48 hours, tinidazole alone did not show significant killing of the entire bacterial population, whereas reductions in the initial inocula > or =2.09 log(10) CFU/ml with clindamycin, > or =3.26 log(10) CFU/ml with amoxicillin/clavulanic acid, and > or =3.83 log(10) CFU/ml with levofloxacin were obtained. When combined with tinidazole, reductions were significantly higher for all antibiotics: > or =5.28 log(10) CFU/ml with clindamycin, > or =4.78 log(10) CFU/ml with amoxicillin/clavulanic acid, and > or =6.17 log(10) CFU/ml with levofloxacin.
  
  
  CONCLUSIONS
  In addition to its high activity against anaerobic periodontal pathogens, tinidazole offered synergism with other antibiotics against the large strict anaerobic subpopulation and the small facultative subpopulation of a high-density mixed inocula of odontogenic pathogens under strict anaerobic conditions, similar to those of odontogenic infections.
authors.affiliation: Department of Microbiology, School of Medicine, Universidad Complutense, 28040 Madrid, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Alou
authors.forename: M J
authors.initials: MJ
authors.lastname: Giménez
authors.forename: F
authors.initials: F
authors.lastname: Manso
authors.forename: D
authors.initials: D
authors.lastname: Sevillano
authors.forename: F
authors.initials: F
authors.lastname: Cafini
authors.forename: M
authors.initials: M
authors.lastname: Torrico
authors.forename: N
authors.initials: N
authors.lastname: González
authors.forename: J
authors.initials: J
authors.lastname: Prieto
authors.forename: J J
authors.initials: JJ
authors.lastname: Alió
authors.forename: L
authors.initials: L
authors.lastname: Aguilar
mesh_terms: D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001421:Bacteria, Anaerobic / Q000187:drug effects*; D019818:Clavulanic Acid / Q000008:administration & dosage; D002981:Clindamycin / Q000008:administration & dosage; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005883:Gingival Crevicular Fluid / Q000382:microbiology; D006801:Humans; D064704:Levofloxacin; D008826:Microbial Sensitivity Tests; D050296:Microbial Viability; D015242:Ofloxacin / Q000008:administration & dosage; D010510:Periodontal Diseases / Q000188:drug therapy* / Q000382:microbiology; D014011:Tinidazole / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D014011:Tinidazole; D019818:Clavulanic Acid; D002981:Clindamycin; D064704:Levofloxacin; D000658:Amoxicillin; D015242:Ofloxacin