심한 근관 감염에서의 항생제 선택

Antimicrobial choice of severe endodontic infection

  • 조주연 (경북대학교 치의학전문대학원 치과보존학교실) ;
  • 하정홍 (경북대학교 치의학전문대학원 치과보존학교실) ;
  • 진명욱 (경북대학교 치의학전문대학원 치과보존학교실) ;
  • 김영경 (경북대학교 치의학전문대학원 치과보존학교실) ;
  • 김성교 (경북대학교 치의학전문대학원 치과보존학교실)
  • Cho, Ju-Yeon (Department of Conservative Dentistry, Kyungpook National University,) ;
  • Ha, Jung-Hong (Department of Conservative Dentistry, Kyungpook National University,) ;
  • Jin, Myoung-Uk (Department of Conservative Dentistry, Kyungpook National University,) ;
  • Kim, Young-Kyung (Department of Conservative Dentistry, Kyungpook National University,) ;
  • Kim, Sung-Kyo (Department of Conservative Dentistry, Kyungpook National University,)
  • 투고 : 2014.03.26
  • 심사 : 2014.05.22
  • 발행 : 2014.07.01

초록

Objectives : The purpose of our study was to evaluate penicillin as a still drug of choice for severe endodontic infection, by analyzing the antimicrobial susceptibilities from endodontic infections with swelling to figure out appropriate antibiotics as empirical treatment. Materials and methods : This study involved 18 patients who attended for emergency treatment because of facial or periapical swelling associated with root canal infections. Identification and antimicrobial susceptibility test of each pathogen were performed by Vitek2 Systems (bioM$\acute{e}$rieux, Marcy l'Etoile, France). Results : The most frequent bacteria was Streptococcus spp.(77%), and the resistance against penicillin was 35% in overall patients, followed by clindamycin and erythromycin (17%), which was much higher than previous studies. Conclusions : In our study, the higher resistance made penicillin alone not to be chosen as the first antibiotic drug for severe endodontic infections. Combinations with other drug, penicillin with wider spectrum of activity, or changing to other antibiotics was considered while remembering the increased risk of resistant microorganism.

키워드

참고문헌

  1. Khemaleelakul S, Baumgartner JC, Pruksakorn S. Identification of bacteria in acute endodontic infections and their antimicrobial susceptibility. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(6):746-55. https://doi.org/10.1067/moe.2002.129535
  2. Sundqvist G, Johansson E, Sjogren U. Prevalence of black-pigmented bacteroides species in root canal infections. J Endod. 1989;15(1):13-9. https://doi.org/10.1016/S0099-2399(89)80092-5
  3. Flynn TR, Halpern LR. Antibiotic selection in head and neck infections. Oral Maxillofac Surg Clin North Am. 2003;15(1):17-38. https://doi.org/10.1016/S1042-3699(02)00082-1
  4. Baumgartner JC, Xia T. Antibiotic susceptibility of bacteria associated with endodontic abscesses. J Endod. 2003;29(1):44-7. https://doi.org/10.1097/00004770-200301000-00012
  5. Hawkey PM. The growing burden of antimicrobial resistance. J Antimicrob Chemother. 2008;62 Suppl 1:i1-9. https://doi.org/10.1093/jac/dkn241
  6. Vigil GV, Wayman BE, Dazey SE, Fowler CB, Bradley DV, Jr. Identification and antibiotic sensitivity of bacteria isolated from periapical lesions. J Endod. 1997;23(2):110-4. https://doi.org/10.1016/S0099-2399(97)80256-7
  7. Ranta H, Haapasalo M, Ranta K, Kontiainen S, Kerosuo E, Valtonen V, et al. Bacteriology of odontogenic apical periodontitis and effect of penicillin treatment. Scand J Infect Dis. 1988;20(2):187-92. https://doi.org/10.3109/00365548809032436
  8. Baker PJ, Evans RT, Slots J, Genco RJ. Antibiotic susceptibility of anaerobic bacteria from the human oral cavity. J Dent Res. 1985;64(10):1233-44. https://doi.org/10.1177/00220345850640101201
  9. Lewis MA, MacFarlane TW, McGowan DA. Antibiotic susceptibilities of bacteria isolated from acute dentoalveolar abscesses. J Antimicrob Chemother. 1989;23(1):69-77. https://doi.org/10.1093/jac/23.1.69
  10. Lewis MA, Parkhurst CL, Douglas CW, Martin MV, Absi EG, Bishop PA, et al. Prevalence of penicillin resistant bacteria in acute suppurative oral infection. J Antimicrob Chemother. 1995;35(6):785-91. https://doi.org/10.1093/jac/35.6.785
  11. Brook I, Frazier EH, Gher ME. Aerobic and anaerobic microbiology of periapical abscess. Oral Microbiol Immunol. 1991;6(2):123-5. https://doi.org/10.1111/j.1399-302X.1991.tb00464.x
  12. Ellison SJ. The role of phenoxymethylpenicillin, amoxicillin, metronidazole and clindamycin in the management of acute dentoalveolar abscesses--a review. Br Dent J. 2009;206(7):357-62. https://doi.org/10.1038/sj.bdj.2009.257
  13. Sundqvist G. Ecology of the root canal flora. J Endod. 1992;18(9):427-30. https://doi.org/10.1016/S0099-2399(06)80842-3
  14. Lewis MA, MacFarlane TW, McGowan DA. Quantitative bacteriology of acute dento-alveolar abscesses. J Med Microbiol. 1986;21(2):101-4. https://doi.org/10.1099/00222615-21-2-101
  15. Heimdahl A, von Konow L, Nord CE. Isolation of beta-lactamase-producing Bacteroides strains associated with clinical failures with penicillin treatment of human orofacial infections. Arch Oral Biol. 1980;25(10):689-92. https://doi.org/10.1016/0003-9969(80)90102-8
  16. Kuriyama T, Williams DW, Yanagisawa M, Iwahara K, Shimizu C, Nakagawa K, et al. Antimicrobial susceptibility of 800 anaerobic isolates from patients with dentoalveolar infection to 13 oral antibiotics. Oral Microbiol Immunol. 2007;22(4):285-8. https://doi.org/10.1111/j.1399-302X.2007.00365.x
  17. Skucaite N, Peciuliene V, Vitkauskiene A, Machiulskiene V. Susceptibility of endodontic pathogens to antibiotics in patients with symptomatic apical periodontitis. J Endod. 2010;36(10):1611-6. https://doi.org/10.1016/j.joen.2010.04.009
  18. Sandor GK, Low DE, Judd PL, Davidson RJ. Antimicrobial treatment options in the management of odontogenic infections. J Can Dent Assoc. 1998;64(7):508-14.
  19. Gomes BP, Jacinto RC, Montagner F, Sousa EL, Ferraz CC. Analysis of the antimicrobial susceptibility of anaerobic bacteria isolated from endodontic infections in Brazil during a period of nine years. J Endod. 2011;37(8):1058-62. https://doi.org/10.1016/j.joen.2011.05.015
  20. Poeschl PW, Crepaz V, Russmueller G, Seemann R, Hirschl AM, Ewers R. Endodontic pathogens causing deep neck space infections: clinical impact of different sampling techniques and antibiotic susceptibility. J Endod. 2011;37(9):1201-5. https://doi.org/10.1016/j.joen.2011.05.029
  21. Henry M, Reader A, Beck M. Effect of penicillin on postoperative endodontic pain and swelling in symptomatic necrotic teeth. J Endod. 2001;27(2):117-23. https://doi.org/10.1097/00004770-200102000-00016
  22. Pallasch TJ. Antibiotics for acute orofacial infections. J Calif Dent Assoc. 1993;21(2):34-44.