sitafloxacin and Jaw-Diseases

Bone turnover suppression agents are widely used for prophylaxis of bone metastases from cancer and osteoporosis; the occurrence of their side effect, antiresorptive agent-related osteonecrosis of the jaw (ARONJ), has been increasing. We investigated the relationships between opacification in the nasal sinuses, rhinosinusitis, and ARONJ based on data obtained from oral surgeons.. We examined 132 patients who had been clinically diagnosed with ARONJ based on clinical observations; all patients had undergone treatment at the Departments of Otorhinolaryngology and Oral Surgery. In 16 of the 132 patients, we confirmed a diagnosis of osteonecrosis of the upper jaw and the presence of ipsilateral opacification of the maxillary sinus. We analyzed the data of these 16 patients in detail.. Five of the 16 patients had some nasal symptoms and had been diagnosed with rhinosinusitis. The opacification of the rhinosinuses improved, partially improved, and remained unchanged after treatment in 10, three, and two patients, respectively; notably, imaging assessment could not be conducted after treatment in one case.. Although there is no consensus regarding the treatment of sinusitis accompanying ARONJ, attempts to improve the causal foci and conservative treatment may offer favorable results; thorough investigation is necessary in refractory cases before determining the use of surgery.

Topics: Aged; Aged, 80 and over; Bisphosphonate-Associated Osteonecrosis of the Jaw; Bone Density Conservation Agents; Denosumab; Diphosphonates; Female; Fluoroquinolones; Humans; Jaw Diseases; Male; Middle Aged; Osteonecrosis; Paranasal Sinuses; Rhinitis; Sinusitis; Tomography, X-Ray Computed

In recent years, many authors have reported that bisphosphonate-related osteonecrosis of the jaw(BRONJ)is a side effect of bisphosphonate therapy. However, clinicians have been confused by these reports, as no definitive criteria or treatment guidelines for BRONJ exist. In this paper, we report a patient who had BRONJ(stage 0)after dental extraction. She was successfully treated with sitafloxacin(STFX). A 73-year-old female had been taking 35 mg of alendronate per week for 24 months for the treatment of osteoporosis. She had a 1-month history of pain, suppuration, and a mandibular socket that would not heal after a left molar tooth extraction, despite the administration of antibiotics. A diagnosis of BRONJ(stage 0)was made without exposed bone, and she started 200 mg of STFX per day for 2 weeks, which was reduced to 100 mg per day for a week thereafter. After 3 weeks of STFX treatment, the mandibular wound healed. Furthermore, antimicrobial susceptibility testing against all of the organisms isolated from the pus indicated that STFX exhibited the most potent antimicrobial activity of all the agents. The results of these data suggested that STFX may be an effective antibiotic for BRONJ.

Topics: Aged; Anti-Bacterial Agents; Bisphosphonate-Associated Osteonecrosis of the Jaw; Diphosphonates; Female; Fluoroquinolones; Humans; Jaw Diseases