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Evaluative Studies

Evaluation of bacterial spectrum of orofacial infections and their antibiotic susceptibility
Access this article online Website: www.amsjournal.com DOI: 10.4103/2231-0746.95318 Quick Response Code:

Nagendra S. Chunduri, Krishnaveni Madasu1, Venkateswara R. Goteki, Tanveer Karpe2, Haranadha Reddy
Department of Oral and Maxillofacial Surgery, Panineeya Dental College,Hyderabad, 1Department of Periodontics, GITAM Dental College, Vishakhapatnam, 2Department of Oral and Maxillofacial Surgery, SB Patil Dental College, Bidar, India Address for correspondence: Dr. Nagendra Srinivas Chunduri, Department of Oral and Maxillofacial Surgery, Panineeya Dental College, Hyderabad, India. E-mail: srinivasomfs@gmail.com

ABSTRACT
Introduction: The inappropriate use ofantibiotics has contributed to a worldwide problem of antimicrobial resistance. The objective of present study is to assess the most common microorganisms causing orofacial infections and their antimicrobial susceptibility to routinely used antibiotics in this part of India. Materials and Methods: Sixty eight patients with orofacial infection were selected on the basis of a series of predefined inclusionand exclusion criteria. Samples were collected under aseptic conditions and subjected to culture and antibiotic susceptibility testing. Descriptive statistics were provided. Results: A total of 64 aerobic and 87 anaerobic strains were isolated. The predominant bacteria were Streptococci viridans (64%), Prevotella (43%), Peptostreptococcus (26%), Porphyromonas (7%), and Fusobacterium (14%). Theisolated strains seemed to be highly sensitive to the routinely used antibiotics such as amoxicillin – clavulanate and amoxicillin alone, clindamycin, and levofloxacin. In contrast, more resistance to erythromycin was observed. Conclusion: Amoxicillin still possesses powerful antimicrobial activity against major pathogens in orofacial odontogenic infections. Amoxicillin/clavulanate and clindamycinwould also be advocated as being useful alternatives for the management of severe orofacial infections. However, the findings of this study indicate that erythromycin is of questionable benefit in the treatment of severe orofacial odontogenic infections. Keywords: Amoxicillin, antibiotic susceptibility, microbiological flora, orofacial infections

INTRODUCTION
Orofacial infections have plaguedhumankind for as long as our species has existed. Most of these infections are odontogenic in origin and are one of the most frequently occurring infectious processes known to both antiquity and present day health practice.[1,2] Most of these infections can be managed without the use of antibiotics, for example, by tooth extraction, endodontic therapy, and surgical treatment, including drainage.[3,4]Surgical incision and drainage may also obviate the use of an antibiotic or may increase the effectiveness of an antibiotic as the vascular flow is restored. However, when an acute bacterial infection has progressed or antimicrobial therapy might be of benefit to patients, antibiotics are prescribed.[3,4] Truly we live in the “antibiotic era.” Beginning with early work
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of Sir Alexander Flemingin 1929, when penicillin become the first “miracle drug,” innumerable lives have been saved from such scourges as pneumonia, wound sepsis, and bacteremia.[5] Dentists benefited greatly from discovery of penicillin because most of the orofacial infections are caused by penicillin-sensitive microorganisms.[6] The serious epidemic of penicillin-resistance staphylococcal infections of 1950s and 1960sfinally was resolved by the development of the semisynthetic antibiotics. The microbiological environment has been polluted with bacteria that are resistant to many antibiotics, this alteration in antibiotic sensitivity is now the expected result of wide spread use of antibiotics.[7,8] The risk of the individual patient from a single prescription of antibiotic is small, but altered bacterial flora...