title: The clinical relevance of microbiology specimens in head and neck space infections of odontogenic origin.
abstract: It is common surgical practice to take a specimen for microbial culture and sensitivity when incising and draining infections of odontogenic origin in the head and neck. We aimed to find out if routine testing has any therapeutic value. We retrospectively studied 90 patients (57 male and 33 female) admitted to Northampton General Hospital for treatment of odontogenic infections, and reviewed admission details, antimicrobial treatment, microbiological findings and their sensitivity or resistance, and complications. Specimens were sent from 72 (80%) patients of which 61 (85%) were infected. The most commonly isolated organism was Streptococcus viridans. Interim reports were published after a mean of 3 days (range 1-4), and 94% of patients were discharged within a mean of 2 days (range 0-9) postoperatively. Almost 95% of patients were discharged before results were available, and there were no reported complications. We therefore suggest that microbial culture has little therapeutic value in the management of these patients. With culture and sensitivity tests costing £25 - £30, omission of this practice in the case of uncomplicated (single tissue space) odontogenic infections could save resources in the National Health Service without affecting the care of patients.
authors.affiliation: Northampton General Hospital, Oral and Maxillofacial Department, Cliftonville, Northampton, NN1 5BD, Oral and Maxillofacial Department, Northampton General Hospital (England). Electronic address: Farmahan_1@msn.com.
authors.forename: Samir
authors.initials: S
authors.lastname: Farmahan
authors.affiliation: Northampton General Hospital, Oral and Maxillofacial Department, Cliftonville, Northampton, NN1 5BD, Oral and Maxillofacial Department, Northampton General Hospital (England).
authors.forename: Dery
authors.initials: D
authors.lastname: Tuopar
authors.affiliation: Northampton General Hospital, Oral and Maxillofacial Department, Cliftonville, Northampton, NN1 5BD, Oral and Maxillofacial Department, Northampton General Hospital (England).
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Ameerally
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D012907:Smoking; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D014076:Tooth Diseases / Q000188:drug therapy / Q000382:microbiology*; D034363:Viridans Streptococci / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin
keywords: Dental; Infections; Microbiology; Odontogenic; Relevance; Specimens