Microbiological examination and antibiotic sensitivity of infections in the head and neck. Has anything changed?
Samir Farmahan1, Dery Tuopar1, Phillip J Ameerally1
1Northampton General Hospital, Oral and Maxillofacial department, Cliftonville, Northampton, NN1 5BD, Oral and Maxillofacial Department, Northampton General Hospital (England).
Abstract:
Because of the growing concern about antibiotic resistance, we aimed to investigate whether the microbiological picture and antibiotic sensitivity of infections in the head and neck have changed in the last 30-40 years. We retrospectively studied 150 patients admitted for inpatient treatment of infections in the head and neck, and searched published reports from the last 30 - 40 years for comparison. There were 85 male and 65 female patients (mean age 39 years, range 1-95). Most infections originated from the teeth (n = 111) and skin (n = 16), and the submandibular (69%) and buccal (67%) spaces were involved most often. Multiple spaces were involved in 94 patients. Swabs were taken for culture and sensitivity in 102 cases, and microorganisms were isolated in 91 (89%), of which 67 (74%) were aerobic infections and 24 (26%) were anaerobic. Bacteria were isolated in 87 (96%) cultures of which 60 (69%) were Gram-positive. Gram-positive cocci were isolated in 62% of cultures. The most common bacteria isolated were streptococci. Seventy percent of the bacteria were sensitive to amoxicillin and 84% to amoxicillin and metronidazole; 14% (Staphylococcus aureus from infections of the skin) were resistant to penicillin. A comparison of our results with those found in previous reports shows no significant change in the microbiological picture and antibiotic sensitivity of odontogenic infections in the head and neck over the last 30 - 40 years. Amoxicillin still treats these infections effectively.
Insights
Head and neck infections show no significant change in microbiology or antibiotic sensitivity over 30-40 years. Amoxicillin remains effective for treating these common odontogenic infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Otolaryngology
Background:
- Growing concern regarding antibiotic resistance necessitates updated microbiological data.
- Head and neck infections, often originating from dental or skin sources, pose a significant clinical challenge.
Purpose of the Study:
- To investigate changes in the microbiological landscape and antibiotic sensitivity patterns of head and neck infections over the past 30-40 years.
- To compare current findings with historical data to assess trends in microbial resistance and treatment efficacy.
Main Methods:
- Retrospective study of 150 inpatient cases of head and neck infections.
- Analysis of microbial cultures, including aerobic and anaerobic bacteria, and their antibiotic sensitivities.
- Comparison with published reports from the last 30-40 years.
Main Results:
- Odontogenic infections were the most common source, primarily involving the submandibular and buccal spaces.
- Gram-positive bacteria, particularly streptococci, were the predominant isolates.
- High sensitivity rates were observed for amoxicillin (70%) and amoxicillin/metronidazole (84%), with limited penicillin resistance in Staphylococcus aureus.
Conclusions:
- No significant shifts in the microbiological profile or antibiotic sensitivity of head and neck infections have occurred over the last 30-40 years.
- Amoxicillin continues to be an effective antibiotic for treating these infections.
- Ongoing surveillance is crucial to monitor potential future changes in antibiotic resistance patterns.
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