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Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Feb;89(2):186-92. doi: 10.1067/moe.2000.102040.

Past administration of beta-lactam antibiotics and increase in the emergence of beta-lactamase-producing bacteria in patients with orofacial odontogenic infections.

Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics

T Kuriyama, K Nakagawa, T Karasawa, Y Saiki, E Yamamoto, S Nakamura

Affiliations

  1. Department of Oral and Maxillofacial Surgery, School of Medicine. Kanazawa University, Kanazawa city, Ishikawa, Japan.

PMID: 10673654 DOI: 10.1067/moe.2000.102040

Abstract

OBJECTIVE: The purpose of this study was to determine the current status of beta-lactamase-producing bacteria in orofacial odontogenic infections.

STUDY DESIGN: Microbiologic data regarding purulent exudate from 111 cases with orofacial odontogenic infections were analyzed in relation to the past administration of beta-lactams.

RESULTS: beta-lactamase-producing bacteria were isolated more frequently from the beta-lactam-administered group (38.5%) than from the beta-lactam-nonadministered group (10.9%; P <.005), and they were isolated more frequently as the duration of administration increased. The predominant bacteria isolated included Prevotella (the most frequent isolate), viridans streptococci, Peptostreptococcus, and Fusobacterium, and 7.1% of total isolates produced beta-lactamase. Penicillin and cefazolin worked well with beta-lactamase-nonproducing Prevotella but were remarkably affected by beta-lactamase-producing Prevotella. Cefmetazole, sulbactam/cefoperazone, and imipenem worked well against both types of Prevotella.

CONCLUSIONS: beta-lactams are still suitable for the first antimicrobial therapy in the treatment of these infections. However, because past beta-lactam administration increases the emergence of beta-lactamase-producing bacteria, beta-lactamase-stable antibiotics should be prescribed to patients with unresolved infections who have received beta-lactams.

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