A study to investigate changes in the microbiology and antibiotic sensitivity of head and neck space infections

Due to a growing concern regarding antibiotic resistance, we aim to investigate if there has been a change in the microbiology and antibiotic sensitivity of head and neck space infections over the last 30-40 years.

A retrospective study was undertaken of 100 patients admitted for inpatient management of head and neck infections. A literature search of the data from the last 30-40 years was performed for comparative purposes.

There were 57 male and 43 female patients (average age 37 years). The most common infections were of odontogenic (67) and skin (14) origin. The submandibular (69%) and buccal (60%) spaces were more commonly involved. Sixty-six cases had multiple space involvement. Seventy-eight cases had swabs taken for microbiology culture and sensitivity, with 67 (85.9%) having microorganisms isolated. Fifty (74.6%) of these were aerobic infections and 17 (25.4%) anaerobic. Bacteria were isolated in 64 (95.5%) cultures. 70.1% of the bacteria were gram positive. Gram-positive cocci were isolated in 65.4% of cultures. The most common bacteria isolated were streptococcus. 73.4% of the bacteria were sensitive to amoxicillin and 81.3% sensitive to both amoxicillin and metronidazole. 15.6% were resistant to penicillin, which were Staphylococcus aureus from skin infections.

Comparing our results with a review of the literature shows no significant change in the microbiology and antibiotic sensitivity of odontogenic head and neck infections over the last 30-40 years. Amoxicillin is still shown to be an effective empirical drug for odontogenic head and neck infections.