Microbiological Analysis of a Prospective, Randomized, Double-Blind Trial Comparing Moxifloxacin and Clindamycin in the Treatment of Odontogenic Infiltrates and Abscesses (MOCLI Study).

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Microbiological Analysis of a Prospective, Randomized, Double-Blind Trial Comparing Moxifloxacin and Clindamycin in the Treatment of Odontogenic Infiltrates and Abscesses (MOCLI Study).

Antimicrob Agents Chemother. 2012 Feb 21;

Authors: Sobottka I, Wegscheider K, Balzer L, Böger RH, Hallier O, Giersdorf I, Streichert T, Haddad M, Platzer U, Cachovan G

Abstract
The objective of this study was to identify the oral pathogens found in odontogenic infections, to determine their susceptibility to amoxicillin/clavulanic acid (AMC), clindamycin (CLI), doxycycline (DOX), levofloxacin (LVX), moxifloxacin (MXF), and penicillin (PEN), and to search for an association between specific pathogens and type of infection.Swabs from patients enrolled in a randomized, double-blind phase II trial comparing MXF and CLI in the treatment of odontogenic abscesses or inflammatory infiltrates were cultured on media for aerobes and anaerobes. All bacterial isolates were identified at the species level.Overall, 205 isolates were cultured from 71 patients: 77 viridans streptococci, 56 Prevotella spp., 19 Neisseria spp., 17 Streptococcus (S.) anginosus group and hemolytic streptococci, 15 other anaerobes, and 21 other bacteria. 98% of pathogens were susceptible to MXF, 96% to AMC, 85% to LVX, 67% to PEN, 60% to CLI, and 50% to DOX. S. anginosus group and hemolytic streptococci were found significantly more frequent (p=0.04) in patients with abscesses (12/95) than in patients with infiltrates (5/110). In four patients of the infiltrate group who failed to respond to CLI therapy, three isolates of S. mitis group and four Neisseria spp. resistant to CLI were found.In this study S. anginosus group and hemolytic streptococci were clearly associated with odontogenic abscesses. Our analysis suggests that viridans streptococci and Neisseria spp. have a decisive role in the etiology of odontogenic infiltrates. MXF's high in vitro activity against odontogenic bacteria corresponds well to its clinical results in the treatment of odontogenic abscesses and infiltrates.

PMID: 22354306 [PubMed - as supplied by publisher]

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