9.22.23
Quick Read #62 - #infections #antibiotics #antibioticresistance #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental
The study titled “Antibiotic resistance in severe odontogenic infections of the South Australian population: a 9-year retrospective audit” conducted between 2006 and 2014 in South Australia investigated the prevalence of antibiotic resistance in severe odontogenic infections:
1. Patient Population: Over a 9-year period, the study identified a total of 672 patients with severe odontogenic infections requiring hospital admission in South Australia.
2. Microbiological Data: Clinical microbiological data was available for 447 patients (66.8%), and antibiotic sensitivity panels were performed for 185 patients (27.5%).
3. Polymicrobial Infections: The majority of infections were found to be polymicrobial in nature, involving multiple types of bacteria.
4. Antibiotic Resistance Rates: The study found that the overall rate of antibiotic resistance in severe odontogenic infections was 17.8%. Specifically, resistance rates to common antibiotics were as follows:
• Penicillin: 10.8%
• Amoxicillin: 9.7%
• Amoxicillin/clavulanic acid: 3.2%
• Cephazolin: 2.2%
• Clindamycin: 3.8%
• Erythromycin: 5.9%
5. Multiple Resistant Cases: The majority of cases with antibiotic resistance were resistant to multiple antibiotics (72.7% of all resistant cases). However, when adjusted for multiple resistance between penicillin and non-penicillin-based antibiotics, the rate of multiple resistance was lower (27.3%).
6. Clinical Impact: Infections with identified antibiotic-resistant organisms demonstrated poorer clinical responses to treatment. These patients had longer hospital admissions, longer stays in intensive care, and a greater need for repeat surgical drainage, indicating a failure to respond to initial surgical intervention.
7. Deaths: There were four patient deaths during the study period. Three of these deaths were directly related to head and neck infection with multi-resistant organisms, highlighting the potential severity of antibiotic-resistant odontogenic infections.
8. Concerns and Antibiotic Prescribing: The study highlighted concerns about the increasing use of antimicrobial agents, including inappropriate overprescription by healthcare providers, including dental practitioners, in Australia. The study emphasizes the importance of responsible antibiotic prescribing and early referral to specialists for severe odontogenic infections to reduce morbidity and mortality associated with antibiotic resistance.
References:
• Liau, I., Han, J., Bayetto, K., May, B., Goss, A., Sambrook, P., & Cheng, A. (2018). Antibiotic resistance in severe odontogenic infections of the South Australian population: a 9-year retrospective audit. Australian Dental Journal, 63(2), 187-192.
• ChatGPT. 2023.
