Antibiotic susceptibility of orofacial infections in Bratislava: a 10-year retrospective study

Aim of this study was to analyse causal microbiological agents and their bacterial resistance in orofacial infections requiring hospital admission.

Presented is a 10-year retrospective study of patients hospitalised at a single department in 2014-2023. 744 patients were involved. In the statistical analysis, following data was evaluated: causal microbes and their resistance to Penicillin, Amoxicillin-Clavulanate, Clindamycin and Metronidazole.

Most frequent aetiology was odontogenic with causal tooth in socket (n = 468; 62,9%), followed by odontogenic - post extraction (n = 152; 20.4%), jaw fracture (n = 41; 5.5%), sialadenitis n = 31 (4.2%), osteonecrosis n = 22 (3.0%), oncological diagnosis in head and neck (n = 17; 2.3%), unknown (n = 10; 1.3%) and multiple factors (n = 3; 0.4%). 408 patients (54.8%) underwent extraoral abscess revision, 336 patients (45.2%) patients were treated locally without extraoral revision. In odontogenic group with tooth still present, superior CRP (m = 145.8 mg/l; SD = 117.7) and leukocyte values (m = 13.6*10⁹l; SD = 6.6) were observed in comparison to other groups. There were 698 cultivated bacteria in 362 patients. Most frequent bacteria were Streptococci (n = 162; 23.2%), Prevotella (n = 83; 11.2%) and Parvimonas (n = 65; 9.3%). Clindamycin resistance was highest (n = 180 resistant bacteria; 25.8%), followed by Metronidazole (n = 178; 25.5%), Penicillin (n = 107; 15.3%) and Amoxicillin-Clavulanate (n = 34; 4.9%).

Orofacial infections in head and neck region are mostly of odontogenic origin with causal tooth still in socket. Causal bacteria show a high antibiotic resistance rate, especially to Clindamycin and Metronidazole.

Acquired data will be used to determine guidelines for empirical antibiotic prescription in cases of orofacial infections.