Antimicrobial therapy in the management of odontogenic infections: the penicillin-allergic patient.
Int J Oral Maxillofac Surg
; 53(3): 251-257, 2024 Mar.
Article
in En
| MEDLINE
| ID: mdl-37758642
ABSTRACT
This retrospective analysis was performed to investigate whether clindamycin remains the preferred antibiotic for penicillin-allergic patients with odontogenic infections. The medical records of 311 patients admitted to the study department with odontogenic infections between 2018 and 2022 and treated with either intravenous amoxicillin-clavulanic acid (Augmentin) or intravenous clindamycin were analyzed. The Augmentin-treated group included 268 patients (86.2%) and the clindamycin-treated group included 43 patients (13.8%). Severity parameters did not differ significantly between the two groups, except for a higher prevalence of abscesses in the clindamycin-treated group (58.1% vs 41.0% in the Augmentin-treated group; P = 0.035). The clindamycin-treated group required a longer duration of intravenous antibiotics (P = 0.001) and had a higher rate of treatment failure (14.0% vs 2.2%; P = 0.002) when compared to the Augmentin-treated group, with a seven-fold increased risk of treatment failure. Moreover, significantly more isolated organisms in the clindamycin-treated group were resistant to clindamycin (P = 0.015); these were all Streptococcus anginosus group. Given the higher risk of treatment failure with clindamycin, it is necessary to choose the antibiotic treatment for penicillin-allergic patients carefully. A detailed history and allergy testing followed by combination therapy is recommended, especially in severe cases.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Penicillins
/
Clindamycin
Type of study:
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Int J Oral Maxillofac Surg
Journal subject:
ODONTOLOGIA
Year:
2024
Document type:
Article