Comparison of maxillofacial space infection in diabetic and nondiabetic patients.
BACKGROUND
Orofacial space infections are common presentations in maxillofacial clinics even in the post-antibiotic era. One of the main factors determining the spread of infection is the host defense mechanism. Diabetes is one of the most common systemic illness suppressing the immunity of an individual and increasing their susceptibility to infections. This study was carried out to compare the spaces involved, the severity of infection, the virulent organism, the efficacy of empirical antibiotics, the length of hospital stay, and the complications encountered in the management of maxillofacial space infection of odontogenic origin in diabetic patients as compared with nondiabetic patients.


METHODS
A 4-year prospective study was carried out on patients with maxillofacial space infection of odontogenic origin. The patients were divided into 2 groups on the basis of presence or absence of diabetes.


RESULTS
A total of 111 patients were identified out of which 31 were diabetic. The organisms commonly isolated were Streptococcus species with submandibular space being the most common space involved in both the groups. The empirical antibiotic used was amoxicillin plus clavulanic acid combined with metrogyl in 70.27% cases.


CONCLUSIONS
Streptococcus species is still the most common causative pathogen irrespective of the diabetic status of the patient. The same empirical antibiotic therapy of amoxicillin plus clavulanic acid combined with metrogyl along with hyperglycemia control and surgical drainage of infection yielded satisfactory resolution of infection in the diabetic patients as well.
Rao
Dipesh D
DD
Department of Oral and Maxillofacial Surgery, S.D.M College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India. drdipesh.rao@gmail.com
Desai
Anilkumar
A
Kulkarni
R D
RD
Gopalkrishnan
K
K
Rao
C Bhasker
CB
D000293:Adolescent; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000188:drug therapy*; D004322:Drainage; D004338:Drug Combinations; D005491:Focal Infection, Dental / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D006943:Hyperglycemia / Q000628:therapy; D007710:Klebsiella Infections / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D007902:Length of Stay; D008158:Ludwig's Angina / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D008795:Metronidazole / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009059:Mouth Diseases / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D011446:Prospective Studies; D013290:Streptococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000601:surgery
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D008795:Metronidazole; D019980:Amoxicillin-Potassium Clavulanate Combination