A study to investigate changes in the microbiology and antibiotic sensitivity of head and neck space infections.

BACKGROUND AND OBJECTIVES: Due to a growing concern regarding antibiotic resistance, we aim to investigate if there has been a change in the microbiology and antibiotic sensitivity of head and neck space infections over the last 30-40 years.

PATIENTS AND METHOD: A retrospective study was undertaken of 100 patients admitted for inpatient management of head and neck infections. A literature search of the data from the last 30-40 years was performed for comparative purposes.

RESULTS: There were 57 male and 43 female patients (average age 37 years). The most common infections were of odontogenic (67) and skin (14) origin. The submandibular (69%) and buccal (60%) spaces were more commonly involved. Sixty-six cases had multiple space involvement. Seventy-eight cases had swabs taken for microbiology culture and sensitivity, with 67 (85.9%) having microorganisms isolated. Fifty (74.6%) of these were aerobic infections and 17 (25.4%) anaerobic. Bacteria were isolated in 64 (95.5%) cultures. 70.1% of the bacteria were gram positive. Gram-positive cocci were isolated in 65.4% of cultures. The most common bacteria isolated were streptococcus. 73.4% of the bacteria were sensitive to amoxicillin and 81.3% sensitive to both amoxicillin and metronidazole. 15.6% were resistant to penicillin, which were Staphylococcus aureus from skin infections.

CONCLUSION: Comparing our results with a review of the literature shows no significant change in the microbiology and antibiotic sensitivity of odontogenic head and neck infections over the last 30-40 years. Amoxicillin is still shown to be an effective empirical drug for odontogenic head and neck infections.