J Korean Assoc Oral Maxillofac Surg.  2015 Aug;41(4):176-180. 10.5125/jkaoms.2015.41.4.176.

A comparative analysis of odontogenic maxillofacial infections in diabetic and nondiabetic patients: an institutional study

• Kamat RD
• Dhupar V
• Akkara F
• Shetye O

• KMID: 2364013
• DOI: http://doi.org/10.5125/jkaoms.2015.41.4.176

Abstract

OBJECTIVES
The increased prevalence of antibiotic resistance is an outcome of evolution. Most patients presenting with odontogenic space infections also have associated systemic co-morbidities such as diabetes mellitus resulting in impaired host defense. The present study aims to compare the odontogenic spaces involved, antibiotic susceptibility of microorganisms, length of hospital stay, and the infl uence of systemic comorbidities on treatment outcome in diabetic patients.
MATERIALS AND METHODS
A 2-year prospective study from January 2012 to January 2014 was conducted on patients with odontogenic maxillofacial space infections. The patients were divided into two groups based on their glycemic levels. The data were compiled and statistically analyzed.
RESULTS
A total of 188 patients were included in the study that underwent surgical incision and drainage, removal of infection source, specimen collection for culture-sensitivity, and evaluation of diabetic status. Sixty-one out of 188 patients were found to be diabetic. The submandibular space was the most commonly involved space, and the most prevalent microorganism was Klebsiella pneumoniae in diabetics and group D Streptococcus in the nondiabetic group.
CONCLUSION
The submandibular space was found to be the most commonly involved space, irrespective of glycemic control. Empiric antibiotic therapy with amoxicillin plus clavulanic acid combined with metronidazole with optimal glycemic control and surgical drainage of infection led to resolution of infection in diabetic as well as nondiabetic patients. The average length of hospital stay was found to be relatively longer in diabetic individuals.

Keyword

Comparative analysis; Odontogenic; Diabetics; Infection

MeSH Terms

Amoxicillin
Clavulanic Acid
Comorbidity
Diabetes Mellitus
Drainage
Drug Resistance, Microbial
Humans
Klebsiella pneumoniae
Length of Stay
Metronidazole
Prevalence
Prospective Studies
Specimen Handling
Streptococcus
Treatment Outcome
Amoxicillin
Clavulanic Acid
Metronidazole

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