članak: 1 od 1  
Vojnosanitetski pregled
2009, vol. 66, br. 7, str. 544-550
jezik rada: engleski
originalan članak
doi:10.2298/VSP0907544M

Empirijska antimikrobna terapija za akutni dentoalveolarni apsces
Vojnomedicinska akademija

e-adresa: drmatijevic@sezampro.yu

Sažetak

Uvod/Cilj. Najčešći uzročnici akutnih dentogenih infekcija jesu oralne streptokoke i anaerobne bakterije. Akutne dentoalveolarne infekcije leče se hirurški u kombinaciji sa antibioticima. Empirijska terapija kod ovih infekcija zasniva se na davanju antibiotika na bazi penicilina. Cilj ove studije bio je da se utvrdi klinička efikasnost peroralne primene amoksicilina i cefaleksina u empirijskom započinjanju lečenja akutnih dentogenih apscesa, kao i da se ispita antimikrobna osetljivost izolovanih sojeva bakterija na ove antibiotike u ranoj fazi njihovog razvoja. Metode. U istraživanje bilo je uključeno 90 ispitanika sa dentogenim apscesima koji su hirurški lečeni (ekstrakcija zuba i/ili incizija apscesa) i svrstani u tri grupe: dve hirurškoantibiotske grupe (amoksicilin, cefaleksin) i hiruršku grupu. U cilju procene efekata primenjene terapije praćeni su sledeći znaci i simptomi: zapaljenski otok, trizmus, regionalni limfadentitis i febrilnost. Kod svih bolesnika, pre terapije uzet je sadržaj eksudata iz apscesa i određena je osetljivost izolovanih bakterija prema antibioticima. Rezultati. U grupi ispitanika koji su dobijali cefaleksin znaci i simptomi infekcije trajali su u proseku 4,67 dana, u grupi koja je primala amoksicilin 4,47 dana, a u hirurškoj grupi u proseku 6,17 dana. U 90 bakterioloških nalaza izolovano je 111 različitih bakterijskih sojeva. Najzastupljenije bile su fakultativno anaerobne gram-pozitivne bakterije (81,1%), a predominantno zastupljena bakterija bila je Streptococcus viridans (68/111). Ukupna osetljivost izolovanih bakterija na amoksicilin iznosila je 76,6%, a na cefaleksin 89,2%. Zaključak. Peroralna primena amoksicilina ili cefaleksina u ranoj fazi razvoja apscesa, nakon primene hirurškog metoda lečenja, statistički značajno skraćuje trajanje kliničkih simptoma akutne dentogene infekcije u odnosu na one koji su lečeni samo hirurškim metodom. Izolovani bakterijski sojevi u ranoj fazi razvoja apscesa pokazuju visoku osetljivost na amoksicilin i cefaleksin.

Ključne reči

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