amoxicillin-potassium-clavulanate-combination and Periapical-Periodontitis

Samples were taken under strictly anaerobic conditions from the root canals of 22 patients having a tooth in which necrotic pulp was associated with an inflammatory peri-apical lesion an optical periodontitis. In the majority of cases (85%), these lesions were chronic and the pulp chamber was closed. One hundred and two strains were isolated, 71.7% of the bacteria being obligate anaerobes and 49.8% being Gram-negative bacilli. Their ability to produce beta-lactamases was tested and 8.8% gave a positive reaction in a cefinase test. These cefinase positive strains were nevertheless susceptible to 3rd-generation cephalosporins (cefoxitin) and to amoxicillin-clavulanate, with the exception of M. Morganii.

Topics: Actinomyces; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacteriological Techniques; Bacteroides; beta-Lactam Resistance; beta-Lactamases; Cefoxitin; Cephalosporins; Dental Pulp Cavity; Dental Pulp Necrosis; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Indicators and Reagents; Peptostreptococcus; Periapical Periodontitis; Prevotella; Streptococcus

An evaluation is made of bacterial species and susceptibility to various antibiotics used in application to odontogenic infections of periapical location and in pericoronitis of the lower third molar, with the aim of optimizing the antibiotherapy of such infections and thus preventing unnecessary side effects and over-treatment.. Sixty-four patients with odontogenic infection were selected on the basis of a series of inclusion and exclusion criteria. Samples were collected from lesions under maximally aseptic conditions, avoiding oral saprophytic contamination. The samples were cultured and incubated under aerobic and anaerobic conditions, followed by bacteriological identification and antibiotic susceptibility testing.. A total of 184 bacterial strains were isolated and identified, comprising grampositive facultative anaerobes (68%), gramnegative strict anaerobes (30%) and grampositive facultative anaerobes (2%). Regardless of the origin of the odontogenic infection, the causal bacteria yielded the best results in terms of increased sensitivity and lesser resistance with amoxicillin / clavulanate and amoxicillin, respectively (p<0.05).. There are increasingly numerous reports in the literature of growing bacterial resistance to antibiotics in infectious processes affecting non-buccodental territories. This same tendency has not been observed in relation to oral infections, though important resistance has been documented for certain concrete antibiotics. According to our results, the common-use antibiotics with the greatest sensitivity and lowest resistance were shown to be amoxicillin/clavulanate followed by amoxicillin alone.

Topics: Acetamides; Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacteria, Anaerobic; Clindamycin; Drug Resistance, Bacterial; Female; Focal Infection, Dental; Humans; Linezolid; Male; Metronidazole; Microbial Sensitivity Tests; Middle Aged; Molar, Third; Oxazolidinones; Periapical Periodontitis; Pericoronitis; Tetracycline

To discuss a rare, but severe complication arising following routine root canal treatment.. An orbital abscess is reported that occurred following routine root canal treatment. A young, healthy female patient, with no history of chronic paranasal infection had undergone root canal treatment of the right maxillary first molar. On hospital admission, she presented with extensive periorbital swelling and discreet diplopia. Computed tomography imaging identified massive purulent sinusitis and subsequent involvement of the orbit via the inferior and medial orbital wall within 48 h after completion of root canal treatment. Immediate surgical drainage of the maxillary sinus and the orbit was established and a high dose of perioperative antibiotics (Amoxicillin/Clavulanic acid, Gentamycin, Metronidazole) were administered. Vision remained undisturbed and mobility of the globe recovered within 10 days.. Rapid exacerbation of a periapical inflammation may occur following root canal treatment and may even involve the orbit. A typical speed of disease progression or ophthalmic symptoms should alert the clinician to at least consider unusual early orbital spread of odontogenic infection. When extra-alveolar spread and especially orbital spread is suspected, immediate referral to a maxillofacial or other specialized unit is mandatory.

Topics: Abscess; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Drainage; Drug Combinations; Female; Gentamicins; Humans; Maxilla; Maxillary Sinusitis; Metronidazole; Molar; Orbital Diseases; Periapical Periodontitis; Root Canal Therapy; Tomography, X-Ray Computed

The purpose of the present study was to investigate the correlation between the composition of the bacterial flora isolated from infected root canals of teeth with apical periodontitis with the presence of clinical signs and symptoms, and to test the antibiotic susceptibility of five anaerobic bacteria mostly commonly found in the root canals of symptomatic teeth against various substances using the E-test. Microbial samples were taken from 48 root canals, 29 symptomatic and 19 asymptomatic, using adequate techniques. A total of 218 cultivable isolates were recovered from 48 different microbial species and 19 different genera. Root canals from symptomatic teeth harbored more obligate anaerobes and a bigger number of bacterial species than the asymptomatic teeth. More than 70% of the bacterial isolates were strict anaerobes. Statistical analysis used a Pearson Chi-squared test or a one-sided Fisher's Exact test as appropriate. Suggested relationships were found between specific microorganisms, especially gram-negative anaerobes, and the presence of spontaneous or previous pain, tenderness to percussion, pain on palpation and swelling amoxicillin, amoxicillin + clavulanate and cephaclor were effective against all the strains tested. The lowest susceptibility rate was presented by Prevotella intermedia/nigrescens against Penicillin G. Our results suggested that specific bacteria are associated with endodontic symptoms of infected teeth with periapical periodontitis and the majority of the anaerobic bacterial species tested were susceptible to all antibiotics studied.

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacteria, Anaerobic; Cefaclor; Chi-Square Distribution; Dental Pulp Cavity; Drug Therapy, Combination; Edema; Female; Gram-Negative Anaerobic Bacteria; Gram-Negative Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pain; Penicillins; Periapical Periodontitis