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Erschienen in: wissen kompakt 3/2021

17.08.2021 | Allgemeine Zahnheilkunde | CME Zahnärztliche Fortbildung

Antibiotika bei odontogenen Infektionen

Grundlagen, Indikationen, Risiken und Resistenzen

verfasst von: PD Dr. med. Dr. med. dent. habil. J. Heider, B. Al-Nawas

Erschienen in: wissen kompakt | Ausgabe 3/2021

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Zusammenfassung

Odontogene Infektionen treten in der zahnärztlichen Praxis häufig und regelmäßig auf. Neben der Inzision der odontogenen Infektion kommen bei Patienten mit Risikofaktoren oder einer Ausbreitungstendenz Antibiotika zum Einsatz. Hierfür werden Penicilline (Aminopenicilline) ohne oder mit Betalaktamaseinhibitor verwendet. Bei einer Allergie gegen Penicilline wird die Verwendung von Clindamycin empfohlen. Die Resistenzdaten weisen abhängig von der Anzahl der verschriebenen Antibiotika Unterschiede zwischen Ländern auf. In Deutschland können Penicilline und bei einer Allergie Clindamycin weiter empfohlen werden. Fluorchinolone, Nitroimidazole und bei einem kritischen Verlauf Carbapeneme stehen als Ausweichpräparate nach Antibiogramm unter Beachtung der Nebenwirkungen und Resistenzentwicklungen zur Verfügung.
Literatur
1.
Zurück zum Zitat Seppanen L et al (2010) Changing clinical features of odontogenic maxillofacial infections. Clin Oral Investig 14(4):459–465 PubMedCrossRef Seppanen L et al (2010) Changing clinical features of odontogenic maxillofacial infections. Clin Oral Investig 14(4):459–465 PubMedCrossRef
2.
Zurück zum Zitat Kim MK et al (2012) Factors associated with length of stay and hospital charges for patients hospitalized with mouth cellulitis. Oral Surg Oral Med Oral Pathol Oral Radiol 113(1):21–28 PubMedCrossRef Kim MK et al (2012) Factors associated with length of stay and hospital charges for patients hospitalized with mouth cellulitis. Oral Surg Oral Med Oral Pathol Oral Radiol 113(1):21–28 PubMedCrossRef
3.
Zurück zum Zitat Cachovan G et al (2013) Odontogenic infections: an 8‑year epidemiologic analysis in a dental emergency outpatient care unit. Acta Odontol Scand 71(3–4):518–524 PubMedCrossRef Cachovan G et al (2013) Odontogenic infections: an 8‑year epidemiologic analysis in a dental emergency outpatient care unit. Acta Odontol Scand 71(3–4):518–524 PubMedCrossRef
4.
Zurück zum Zitat Sato FR et al (2009) Eight-year retrospective study of odontogenic origin infections in a postgraduation program on oral and maxillofacial surgery. J Oral Maxillofac Surg 67(5):1092–1097 PubMedCrossRef Sato FR et al (2009) Eight-year retrospective study of odontogenic origin infections in a postgraduation program on oral and maxillofacial surgery. J Oral Maxillofac Surg 67(5):1092–1097 PubMedCrossRef
5.
Zurück zum Zitat Singh M, Kambalimath DH, Gupta KC (2014) Management of odontogenic space infection with microbiology study. J Maxillofac Oral Surg 13(2):133–139 PubMedPubMedCentralCrossRef Singh M, Kambalimath DH, Gupta KC (2014) Management of odontogenic space infection with microbiology study. J Maxillofac Oral Surg 13(2):133–139 PubMedPubMedCentralCrossRef
6.
Zurück zum Zitat Walia IS et al (2014) Microbiology and antibiotic sensitivity of head and neck space infections of odontogenic origin. J Maxillofac Oral Surg 13(1):16–21 PubMedCrossRef Walia IS et al (2014) Microbiology and antibiotic sensitivity of head and neck space infections of odontogenic origin. J Maxillofac Oral Surg 13(1):16–21 PubMedCrossRef
7.
Zurück zum Zitat Eckert AW et al (2012) Dentogenic infections—part I: the significance of bacterial isolation of dentogenic infections under routineous conditions. Wien Med Wochenschr 162(13–14):316–320 PubMedCrossRef Eckert AW et al (2012) Dentogenic infections—part I: the significance of bacterial isolation of dentogenic infections under routineous conditions. Wien Med Wochenschr 162(13–14):316–320 PubMedCrossRef
8.
Zurück zum Zitat Chi TH, Tsao YH, Yuan CH (2014) Influences of patient age on deep neck infection: clinical etiology and treatment outcome. Otolaryngol Head Neck Surg 151(4):586–590 PubMedCrossRef Chi TH, Tsao YH, Yuan CH (2014) Influences of patient age on deep neck infection: clinical etiology and treatment outcome. Otolaryngol Head Neck Surg 151(4):586–590 PubMedCrossRef
9.
Zurück zum Zitat Chunduri NS et al (2012) Evaluation of bacterial spectrum of orofacial infections and their antibiotic susceptibility. Ann Maxillofac Surg 2(1):46–50 PubMedPubMedCentralCrossRef Chunduri NS et al (2012) Evaluation of bacterial spectrum of orofacial infections and their antibiotic susceptibility. Ann Maxillofac Surg 2(1):46–50 PubMedPubMedCentralCrossRef
10.
Zurück zum Zitat Sanchez R et al (2011) Severe odontogenic infections: epidemiological, microbiological and therapeutic factors. Med Oral Patol Oral Cir Bucal 16(5):e670–6 PubMedCrossRef Sanchez R et al (2011) Severe odontogenic infections: epidemiological, microbiological and therapeutic factors. Med Oral Patol Oral Cir Bucal 16(5):e670–6 PubMedCrossRef
11.
Zurück zum Zitat Hasegawa J et al (2011) An analysis of clinical risk factors of deep neck infection. Auris Nasus Larynx 38(1):101–107 PubMedCrossRef Hasegawa J et al (2011) An analysis of clinical risk factors of deep neck infection. Auris Nasus Larynx 38(1):101–107 PubMedCrossRef
12.
Zurück zum Zitat Poeschl PW et al (2010) Antibiotic susceptibility and resistance of the odontogenic microbiological spectrum and its clinical impact on severe deep space head and neck infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110(2):151–156 PubMedCrossRef Poeschl PW et al (2010) Antibiotic susceptibility and resistance of the odontogenic microbiological spectrum and its clinical impact on severe deep space head and neck infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110(2):151–156 PubMedCrossRef
14.
Zurück zum Zitat Bakathir AA et al (2009) Factors contributing to the spread of odontogenic infections: a prospective pilot study. Sultan Qaboos Univ Med J 9(3):296–304 PubMedPubMedCentral Bakathir AA et al (2009) Factors contributing to the spread of odontogenic infections: a prospective pilot study. Sultan Qaboos Univ Med J 9(3):296–304 PubMedPubMedCentral
15.
Zurück zum Zitat Seppanen L et al (2008) Analysis of systemic and local odontogenic infection complications requiring hospital care. J Infect 57(2):116–122 PubMedCrossRef Seppanen L et al (2008) Analysis of systemic and local odontogenic infection complications requiring hospital care. J Infect 57(2):116–122 PubMedCrossRef
16.
Zurück zum Zitat Al-Nawas B, Maeurer M (2008) Severe versus local odontogenic bacterial infections: comparison of microbial isolates. Eur Surg Res 40(2):220–224 PubMedCrossRef Al-Nawas B, Maeurer M (2008) Severe versus local odontogenic bacterial infections: comparison of microbial isolates. Eur Surg Res 40(2):220–224 PubMedCrossRef
17.
Zurück zum Zitat Suehara AB et al (2008) Deep neck infection: analysis of 80 cases. Braz J Otorhinolaryngol 74(2):253–259 PubMedCrossRef Suehara AB et al (2008) Deep neck infection: analysis of 80 cases. Braz J Otorhinolaryngol 74(2):253–259 PubMedCrossRef
18.
Zurück zum Zitat Rega AJ, Aziz SR, Ziccardi VB (2006) Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin. J Oral Maxillofac Surg 64(9):1377–1380 PubMedCrossRef Rega AJ, Aziz SR, Ziccardi VB (2006) Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin. J Oral Maxillofac Surg 64(9):1377–1380 PubMedCrossRef
19.
Zurück zum Zitat Kudiyirickal MG, Hollinshead F (2012) Clinical profile of orofacial infections: an experience from two primary care dental practices. Med Oral Patol Oral Cir Bucal 17(4):e533–7 PubMedPubMedCentralCrossRef Kudiyirickal MG, Hollinshead F (2012) Clinical profile of orofacial infections: an experience from two primary care dental practices. Med Oral Patol Oral Cir Bucal 17(4):e533–7 PubMedPubMedCentralCrossRef
20.
Zurück zum Zitat Moghimi M et al (2013) Spread of odontogenic infections: a retrospective analysis and review of the literature. Quintessence Int 44(4):351–361 PubMed Moghimi M et al (2013) Spread of odontogenic infections: a retrospective analysis and review of the literature. Quintessence Int 44(4):351–361 PubMed
21.
Zurück zum Zitat Blake FA et al (2006) The acute orbit: etiology, diagnosis, and therapy. J Oral Maxillofac Surg 64(1):87–93 PubMedCrossRef Blake FA et al (2006) The acute orbit: etiology, diagnosis, and therapy. J Oral Maxillofac Surg 64(1):87–93 PubMedCrossRef
22.
Zurück zum Zitat Eisler L et al (2013) Morbidity and cost of odontogenic infections. Otolaryngol Head Neck Surg 149(1):84–88 PubMedCrossRef Eisler L et al (2013) Morbidity and cost of odontogenic infections. Otolaryngol Head Neck Surg 149(1):84–88 PubMedCrossRef
23.
Zurück zum Zitat Rasteniene R, Aleksejuniene J, Puriene A (2015) Determinants of length of hospitalization due to acute odontogenic maxillofacial infections: a 2009–2013 retrospective analysis. Med Princ Pract 24(2):129–135 PubMedPubMedCentralCrossRef Rasteniene R, Aleksejuniene J, Puriene A (2015) Determinants of length of hospitalization due to acute odontogenic maxillofacial infections: a 2009–2013 retrospective analysis. Med Princ Pract 24(2):129–135 PubMedPubMedCentralCrossRef
24.
Zurück zum Zitat Lee JK, Kim HD, Lim SC (2007) Predisposing factors of complicated deep neck infection: an analysis of 158 cases. Yonsei Med J 48(1):55–62 PubMedPubMedCentralCrossRef Lee JK, Kim HD, Lim SC (2007) Predisposing factors of complicated deep neck infection: an analysis of 158 cases. Yonsei Med J 48(1):55–62 PubMedPubMedCentralCrossRef
25.
Zurück zum Zitat Opitz D et al (2015) Incidence and management of severe odontogenic infections—a retrospective analysis from 2004 to 2011. J Craniomaxillofac Surg 43(2):285–289 PubMedCrossRef Opitz D et al (2015) Incidence and management of severe odontogenic infections—a retrospective analysis from 2004 to 2011. J Craniomaxillofac Surg 43(2):285–289 PubMedCrossRef
26.
Zurück zum Zitat Sakarya EU et al (2015) Clinical features of deep neck infection: analysis of 77 patients. Kulak Burun Bogaz Ihtis Derg 25(2):102–108 PubMedCrossRef Sakarya EU et al (2015) Clinical features of deep neck infection: analysis of 77 patients. Kulak Burun Bogaz Ihtis Derg 25(2):102–108 PubMedCrossRef
27.
Zurück zum Zitat Boffano P et al (2012) Management of 112 hospitalized patients with spreading odontogenic infections: correlation with DMFT and oral health impact profile 14 indexes. Oral Surg Oral Med Oral Pathol Oral Radiol 113(2):207–213 PubMedCrossRef Boffano P et al (2012) Management of 112 hospitalized patients with spreading odontogenic infections: correlation with DMFT and oral health impact profile 14 indexes. Oral Surg Oral Med Oral Pathol Oral Radiol 113(2):207–213 PubMedCrossRef
28.
Zurück zum Zitat Zhang C et al (2010) Maxillofacial space infection experience in West China: a retrospective study of 212 cases. Int J Infect Dis 14(5):e414–7 PubMedCrossRef Zhang C et al (2010) Maxillofacial space infection experience in West China: a retrospective study of 212 cases. Int J Infect Dis 14(5):e414–7 PubMedCrossRef
29.
Zurück zum Zitat Huang TT et al (2004) Deep neck infection: analysis of 185 cases. Head Neck 26(10):854–860 PubMedCrossRef Huang TT et al (2004) Deep neck infection: analysis of 185 cases. Head Neck 26(10):854–860 PubMedCrossRef
30.
Zurück zum Zitat Pourdanesh F et al (2013) Pattern of odontogenic infections at a tertiary hospital in tehran, iran: a 10-year retrospective study of 310 patients. J Dent (Tehran) 10(4):319–328 Pourdanesh F et al (2013) Pattern of odontogenic infections at a tertiary hospital in tehran, iran: a 10-year retrospective study of 310 patients. J Dent (Tehran) 10(4):319–328
31.
Zurück zum Zitat Weise H et al (2019) Severe odontogenic infections with septic progress—a constant and increasing challenge: a retrospective analysis. BMC Oral Health 19(1):173 PubMedPubMedCentralCrossRef Weise H et al (2019) Severe odontogenic infections with septic progress—a constant and increasing challenge: a retrospective analysis. BMC Oral Health 19(1):173 PubMedPubMedCentralCrossRef
32.
Zurück zum Zitat Cachovan G et al (2011) Comparative efficacy and safety of moxifloxacin and clindamycin in the treatment of odontogenic abscesses and inflammatory infiltrates: a phase II, double-blind, randomized trial. Antimicrob Agents Chemother 55(3):1142–1147 PubMedCrossRef Cachovan G et al (2011) Comparative efficacy and safety of moxifloxacin and clindamycin in the treatment of odontogenic abscesses and inflammatory infiltrates: a phase II, double-blind, randomized trial. Antimicrob Agents Chemother 55(3):1142–1147 PubMedCrossRef
33.
Zurück zum Zitat Sobottka I et al (2002) In vitro activity of moxifloxacin against bacteria isolated from odontogenic abscesses. Antimicrob Agents Chemother 46(12):4019–4021 PubMedPubMedCentralCrossRef Sobottka I et al (2002) In vitro activity of moxifloxacin against bacteria isolated from odontogenic abscesses. Antimicrob Agents Chemother 46(12):4019–4021 PubMedPubMedCentralCrossRef
34.
Zurück zum Zitat Eick S et al (2000) Pathogen and resistance spectrum in intraoral infections of the jaw-facial area with special reference to anaerobic bacteria. Mund Kiefer Gesichtschir 4(4):234–239 PubMedCrossRef Eick S et al (2000) Pathogen and resistance spectrum in intraoral infections of the jaw-facial area with special reference to anaerobic bacteria. Mund Kiefer Gesichtschir 4(4):234–239 PubMedCrossRef
35.
Zurück zum Zitat Sobottka I et al (2012) Microbiological analysis of a prospective, randomized, double-blind trial comparing moxifloxacin and clindamycin in the treatment of odontogenic infiltrates and abscesses. Antimicrob Agents Chemother 56(5):2565–2569 PubMedPubMedCentralCrossRef Sobottka I et al (2012) Microbiological analysis of a prospective, randomized, double-blind trial comparing moxifloxacin and clindamycin in the treatment of odontogenic infiltrates and abscesses. Antimicrob Agents Chemother 56(5):2565–2569 PubMedPubMedCentralCrossRef
36.
Zurück zum Zitat Martins JR et al (2017) The use of antibiotics in odontogenic infections: what is the best choice? A systematic review. J Oral Maxillofac Surg 75(12):2606.e1–2606.e11 CrossRef Martins JR et al (2017) The use of antibiotics in odontogenic infections: what is the best choice? A systematic review. J Oral Maxillofac Surg 75(12):2606.e1–2606.e11 CrossRef
37.
Zurück zum Zitat Warnke PH et al (2008) Penicillin compared with other advanced broad spectrum antibiotics regarding antibacterial activity against oral pathogens isolated from odontogenic abscesses. J Craniomaxillofac Surg 36(8):462–467 PubMedCrossRef Warnke PH et al (2008) Penicillin compared with other advanced broad spectrum antibiotics regarding antibacterial activity against oral pathogens isolated from odontogenic abscesses. J Craniomaxillofac Surg 36(8):462–467 PubMedCrossRef
38.
Zurück zum Zitat Flynn TR (2011) What are the antibiotics of choice for odontogenic infections, and how long should the treatment course last? Oral Maxillofac Surg Clin North Am 23(4):519–536 PubMedCrossRef Flynn TR (2011) What are the antibiotics of choice for odontogenic infections, and how long should the treatment course last? Oral Maxillofac Surg Clin North Am 23(4):519–536 PubMedCrossRef
39.
Zurück zum Zitat Zirk M et al (2016) Empiric systemic antibiotics for hospitalized patients with severe odontogenic infections. J Craniomaxillofac Surg 44(8):1081–1088 PubMedCrossRef Zirk M et al (2016) Empiric systemic antibiotics for hospitalized patients with severe odontogenic infections. J Craniomaxillofac Surg 44(8):1081–1088 PubMedCrossRef
40.
Zurück zum Zitat van Winkelhoff AJ et al (2000) Antimicrobial resistance in the subgingival microflora in patients with adult periodontitis. A comparison between The Netherlands and Spain. J Clin Periodontol 27(2):79–86 PubMedCrossRef van Winkelhoff AJ et al (2000) Antimicrobial resistance in the subgingival microflora in patients with adult periodontitis. A comparison between The Netherlands and Spain. J Clin Periodontol 27(2):79–86 PubMedCrossRef
41.
Zurück zum Zitat van Winkelhoff AJ et al (2005) Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in The Netherlands and Spain. J Clin Periodontol 32(8):893–898 PubMedCrossRef van Winkelhoff AJ et al (2005) Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in The Netherlands and Spain. J Clin Periodontol 32(8):893–898 PubMedCrossRef
42.
Zurück zum Zitat Bundesamt für Verbraucherschutz und Lebensmittelsicherheit (2016) GERMAP 2015 – Bericht über den Antibiotikaverbrauch und die Verbreitung von Antibiotikaresistenzen in der Human- und Veterinärmedizin in Deutschland. Antiinfectives Intelligence, Rheinbach Bundesamt für Verbraucherschutz und Lebensmittelsicherheit (2016) GERMAP 2015 – Bericht über den Antibiotikaverbrauch und die Verbreitung von Antibiotikaresistenzen in der Human- und Veterinärmedizin in Deutschland. Antiinfectives Intelligence, Rheinbach
43.
Zurück zum Zitat Liau I et al (2018) Antibiotic resistance in severe odontogenic infections of the South Australian population: a 9-year retrospective audit. Aust Dent J 63(2):187–192 PubMedCrossRef Liau I et al (2018) Antibiotic resistance in severe odontogenic infections of the South Australian population: a 9-year retrospective audit. Aust Dent J 63(2):187–192 PubMedCrossRef
44.
Zurück zum Zitat Shakya N et al (2018) Epidemiology, microbiology and antibiotic sensitivity of odontogenic space infections in central India. J Maxillofac Oral Surg 17(3):324–331 PubMedCrossRef Shakya N et al (2018) Epidemiology, microbiology and antibiotic sensitivity of odontogenic space infections in central India. J Maxillofac Oral Surg 17(3):324–331 PubMedCrossRef
45.
Zurück zum Zitat Plum AW, Mortelliti AJ, Walsh RE (2018) Microbial flora and antibiotic resistance in odontogenic abscesses in Upstate New York. Ear Nose Throat J 97(1–2):E27–E31 PubMedCrossRef Plum AW, Mortelliti AJ, Walsh RE (2018) Microbial flora and antibiotic resistance in odontogenic abscesses in Upstate New York. Ear Nose Throat J 97(1–2):E27–E31 PubMedCrossRef
46.
Zurück zum Zitat Lessa FC et al (2015) Burden of clostridium difficile infection in the United States. N Engl J Med 372(9):825–834 PubMedCrossRef Lessa FC et al (2015) Burden of clostridium difficile infection in the United States. N Engl J Med 372(9):825–834 PubMedCrossRef
Metadaten
Titel
Antibiotika bei odontogenen Infektionen
Grundlagen, Indikationen, Risiken und Resistenzen
verfasst von
PD Dr. med. Dr. med. dent. habil. J. Heider
B. Al-Nawas
Publikationsdatum
17.08.2021
Verlag
Springer Medizin
Erschienen in
wissen kompakt / Ausgabe 3/2021
Print ISSN: 1863-2637
Elektronische ISSN: 2190-3816
DOI
https://doi.org/10.1007/s11838-021-00133-5