BACTERIOLOGY, PATHOLOGY AND ANTIBIOTIC SENSITIVITY OF PERIAPICAL INFECTIONS SEEN IN A TERTIARY HEALTH FACILITY

Antibiotic sensitivity of periapical infections

Abstract

inflammatory reactions in the periapical tissues due to the presence of 
polymicrobial organisms and this may result in severe life-threatening 
infections. These lesions remain a public health concern.  
AIM: This study aimed to identify the common bacteria involved in the 
periapical infections in our environment and to assess their susceptibility 
patterns to commonly used antibiotics, in the oral and maxillofacial out
patient clinic. 
METHODS: Consecutive and consenting patients scheduled to have 
their teeth extracted by intra-alveolar protocol for reason of periapical 
infections and who claimed not to have taken antibiotics in the preceding 
one week were recruited into the study population. Nutrient agar, blood 
agar, chocolate agar and MacConkey agar were used for culture and 
antibiotic susceptibility tests. Organisms identified were subjected to 
various antibiotic susceptibility tests, of the commonly prescribed and 
used antibiotics (cefuroxime, erythromycin, gentamycin, ofloxacin, 
levofloxacin, amoxicillin and clavulanate, and obatrin) in the Dental 
Centre, using the disc diffusion method of Bauer and Kirby.  

RESULTS: A total of eight hundred and ninety-eight (898) swabs were 
taken for culture, identification and sensitivity test from 530 females and 
368 males aged 16-80years, presenting with periapical lesions. Of all 
the swabs taken, 135(15%) yielded no growths, 610(68%) yielded single 
organisms and 153(17%) yielded more than one organisms. Isolated 
bacterial organisms were Staphylococcus albus (22.4% of isolates), 
Staphylococcus aureus (50.0% of isolates), Streptococcus mutans 
(14.4% of isolates), Streptococcus viridans (13.0% of isolates) and 
Klebsiella spp (20.0% of isolates). The susceptibility rate of the tested 
antibiotics were amoxicillin and clavulanate 75%, cefuroxime 75%, 
obatrin 68%, ofloxacin 68%, erythromycin 62%, levofloxacin 59% and 
gentamycin 45%.  
CONCLUSION: The study has provided evidence to show that 
facultative Gram positive cocci are the predominant organisms isolated 
from root apices with periapical lesions. Most of these infective 
organisms are susceptible to amoxicillin and clavulanate, and 
cefuroxime. They are resistant mainly to gentamycin.