Bacteremia of dental origin and antimicrobial sensitivity following oral surgical procedures in children

Pediatr Dent. Jan-Feb 1998;20(1):28-36.

Abstract

Methods: The prevalence and intensity of bacteremia of dental origin were examined in 207 children divided into four groups: a baseline with no surgical intervention (group I), after a single tooth extraction (group II), multiple tooth extraction (group III), and mucoperiosteal flap elevation (group IV). The bacterial isolates were grown using a broth culture (Bactec) and lysis centrifugation (Paediatric Isolator) techniques. Dental plaque deposits, gingivitis, spontaneous gingival bleeding and the presence/absence of a dental abscess were recorded and their relationship to bacteremia assessed.

Results: The broth culture was positive for group I 11% of the time, group II for 43%, group III for 54%, and group IV for 43%. The Paediatric Isolator system was found to be a poor method for detecting bacteremia, having only one quarter the sensitivity of the broth culture technique. When organisms were isolated, the intensity of bacteremia ranged from 1 to 3400 colony forming units per milliliter (cfu/mL). Bacterial isolates were susceptible to most of the antibiotics recommended for antibiotic prophylaxis, but erythromycin, gentamycin, penicillin G, and teicoplanin were only 80% (or less) effective in their efficacy while chlorhexidine, amoxicillin, clindamycin, and vancomycin were between 92 and 100% effective.

Conclusions: The antibiotics commonly used for an oral and/or parenteral prophylaxis are likely to be effective on at least 80% of occasions with most of them effective on 100% of occasions.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Amoxicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents, Local / therapeutic use
  • Bacteremia / etiology*
  • Bacteremia / microbiology
  • Bacteria / classification
  • Bacteria / drug effects*
  • Bacteria / growth & development
  • Centrifugation
  • Child
  • Chlorhexidine / therapeutic use
  • Clindamycin / therapeutic use
  • Colony Count, Microbial
  • Culture Media
  • Dental Care for Children
  • Drug Resistance, Microbial
  • Erythromycin / therapeutic use
  • Gentamicins / therapeutic use
  • Humans
  • Oral Surgical Procedures / adverse effects*
  • Penicillin G / therapeutic use
  • Penicillins / therapeutic use
  • Prevalence
  • Surgical Flaps / adverse effects
  • Teicoplanin / therapeutic use
  • Tooth Extraction / adverse effects
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Culture Media
  • Gentamicins
  • Penicillins
  • Clindamycin
  • Teicoplanin
  • Erythromycin
  • Vancomycin
  • Amoxicillin
  • Penicillin G
  • Chlorhexidine