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Antibiotics
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Antibiotic Treatment of Oral Infections
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Antibiotic Treatment of Oral Infections

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 17008

Special Issue Editor

Dr. Thomas E. Rams

E-Mail Website
Guest Editor
Department of Periodontology and Oral Implantology, Temple University School of Dentistry, Philadelphia, PA, USA
Interests: clinical periodontal diagnostic microbiology; application of systemic and local antimicrobial agents in periodontal therapy

Special Issue Information

Dear Colleagues,

Antibiotic treatment of oral infections associated with periodontal, peri-implant and endodontic lesions aims to eradicate or control bacterial pathogens by augmenting the antimicrobial effects of mechanical debridement/local antiseptics, and support protective host defenses. Such systemic and/or local antibiotic therapy, if appropriately administered, is often decisive in clinically arresting progressive oral infections and reducing systemic manifestations. 

However, many issues remain unresolved regarding the administration of antibiotics for oral infections, especially in determining proper patient and drug selection, as well as the dosing and timing of drug regimens. Moreover, the increasing emergence of antibiotic resistance in the oral microbiome and microbial communities at other body sites threatens the efficacy and safety of antibiotic-based treatment regimens in the oral cavity. 

This Special Issue seeks to delineate current knowledge on the advantages, indications, and limitations of antibiotics in human periodontal, peri-implant and endodontic therapy. Clinical trials, human observational studies, case series reports, in vitro laboratory studies, and systematic/scoping reviews and meta-analyses providing new insights into the antibiotic treatment of oral microbial infections are welcomed. Since antibiotic resistance patterns may vary over time and geographically, new surveillance studies on the antibiotic susceptibility of oral microbial pathogens from various regions across the world, particularly those that are longitudinal in scope, are especially desirable and sought. From these contributions, this Special Issue can provide an enhanced scientific basis and rationale for the appropriate antibiotic treatment of oral infections for the dental profession and other health practitioners.

Dr. Thomas E. Rams
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Antibiotic resistance
  • Periodontal
  • Periodontitis
  • Apical periodontitis
  • Endodontic
  • Peri-implantitis
  • Peri-implant
  • Systemic and topical antibiotic administration

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Published Papers (5 papers)

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Research

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12 pages, 5973 KiB  
Article
Systemic Antibiotics and Chlorhexidine Associated with Periodontal Therapy: Microbiological Effect on Intraoral Surfaces and Saliva
by Stella de Noronha Campos Mendes, Camila Machado Esteves, Juliana Alethusa Velloso Mendes, Magda Feres, Nathalia Figueiredo, Tamires Szeremeske de Miranda, Jamil Awad Shibli and Luciene Cristina Figueiredo
Antibiotics 2023, 12(5), 847; https://doi.org/10.3390/antibiotics12050847 - 4 May 2023
Cited by 6 | Viewed by 2058
Abstract
The effect of systemic antibiotics on the microbial profile of extracrevicular sites after periodontal treatment is currently the subject of research. This study evaluated the microbiological effects on different oral cavity sites of scaling and root planing (SRP) combined with antimicrobial chemical control [...] Read more.
The effect of systemic antibiotics on the microbial profile of extracrevicular sites after periodontal treatment is currently the subject of research. This study evaluated the microbiological effects on different oral cavity sites of scaling and root planing (SRP) combined with antimicrobial chemical control in the treatment of periodontitis. Sixty subjects were randomly assigned to receive SRP alone or combined with metronidazole (MTZ) + amoxicillin (AMX) for 14 days, with or without chlorhexidine mouth rinse (CHX) for 60 days. Microbiological samples were evaluated by checkerboard DNA–DNA hybridization until 180 days post therapy. The adjunctive use of antibiotics plus CHX significantly reduced the mean proportions of red complex species from subgingival biofilm and saliva (p < 0.05). Furthermore, the analysis of all intraoral niches showed a significantly lower mean proportion of the red complex species in the same group. In conclusion, the concomitant use of antimicrobial chemical control (systemic and local) demonstrated a beneficial effect on the composition of the oral microbiota. Full article
(This article belongs to the Special Issue Antibiotic Treatment of Oral Infections)
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12 pages, 1588 KiB  
Article
Antibiotics to Prevent Surgical Site Infection (SSI) in Oral Surgery: Survey among Italian Dentists
by Marco Lollobrigida, Gianluca Pingitore, Luca Lamazza, Giulia Mazzucchi, Giorgio Serafini and Alberto De Biase
Antibiotics 2021, 10(8), 949; https://doi.org/10.3390/antibiotics10080949 - 6 Aug 2021
Cited by 8 | Viewed by 3415
Abstract
The benefit of an antibiotic prophylaxis for most oral surgical procedures is controversial. The aim of this study was to collect information on the prescribing habits of a sample of Italian dentists with respect to the role of antibiotic prophylaxis in preventing surgical [...] Read more.
The benefit of an antibiotic prophylaxis for most oral surgical procedures is controversial. The aim of this study was to collect information on the prescribing habits of a sample of Italian dentists with respect to the role of antibiotic prophylaxis in preventing surgical site infections (SSI). An anonymous questionnaire was prepared and made accessible online by sharing a Google Forms link. General anagraphic data and educational background information were collected to obtain a profile of the participants. Different clinical scenarios were then proposed, with the participants asked to choose whether they would prescribe an antibiotic prophylaxis and with which dosage regimens. In total, 169 dentists participated in the questionnaire and the obtained data were assessed through a percentage report. The results showed a substantial agreement in antibiotics prescription, but only in a limited number of clinical scenarios, such as deciduous teeth extraction or simple extractions in healthy adult patients. Discordant responses were found for several clinical cases, particularly for cases of comorbidities, surgical or multiple extractions, implant placement and abscess drainage. The answers obtained from the survey sample were notably heterogeneous, indicating that the choice to prescribe an antibiotic prophylaxis to prevent SSIs is often discretionary. Moreover, the dosage regimen of prophylaxis is also controversial. The results of this study demonstrate the need for specific guidelines on antibiotics in dentistry and, specifically, on antibiotic prophylaxis in oral surgery. Such guidelines would help to avoid unnecessary prescriptions. Full article
(This article belongs to the Special Issue Antibiotic Treatment of Oral Infections)
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16 pages, 3800 KiB  
Article
Conservative Management of Medication-Related Osteonecrosis of the Jaws (MRONJ): A Retrospective Cohort Study
by Elena M. Varoni, Niccolò Lombardi, Giulio Villa, Alberto Pispero, Andrea Sardella and Giovanni Lodi
Antibiotics 2021, 10(2), 195; https://doi.org/10.3390/antibiotics10020195 - 17 Feb 2021
Cited by 22 | Viewed by 4116
Abstract
Background: Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of bisphosphonates and anti-resorptive drugs prescribed for treatment of severe osteoporosis, Paget’s disease, and bone malignancies. The aim of this study was to evaluate the clinical outcome of a combined pharmacological [...] Read more.
Background: Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of bisphosphonates and anti-resorptive drugs prescribed for treatment of severe osteoporosis, Paget’s disease, and bone malignancies. The aim of this study was to evaluate the clinical outcome of a combined pharmacological and surgical management strategy on patients affected by MRONJ. Materials and methods: Medical records of patients with MRONJ were retrospectively examined to collect clinical history data. Conservative management included an initial pharmacological phase with antibiotics and antiseptic agents, followed by surgical intervention to remove bone sequestrum. Primary outcomes were healing from MRONJ at short term (1 month after surgery) and at longer term (3 months after surgery). Secondary outcome was assessment of recurrences at longer-term follow-up. Results: Thirty-five patients were included in the study with mean follow-up of 23.86 ± 18.14 months. Seven cases showed spontaneous exfoliation of necrotic bone during pharmacological therapy, which in one case did not require any further intervention. At 1-month posttreatment, 31 out of 35 (88.5%) patients showed complete healing. The 25 patients who were followed for at least 3 months revealed a healing rate of 92% (23/25). Recurrences occurred in 7 patients out 23 who showed the long-term healing, after a mean period of 7.29 ± 3.45 months. The prognostic score (University of Connecticut Osteonecrosis Numerical Scale—UCONNS) was significantly higher (p = 0.01) in patients with poor healing as compared to complete healing, both at 1 and 3 months posttreatment. Conclusions: A MRONJ treatment approach based on a combined pharmacological and surgical treatment strategy showed a high rate of healing and few recurrences. Full article
(This article belongs to the Special Issue Antibiotic Treatment of Oral Infections)
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9 pages, 226 KiB  
Article
Antibiotic Resistance of Human Periodontal Pathogen Parvimonas micra Over 10 Years
by Thomas E. Rams, Jacqueline D. Sautter and Arie J. van Winkelhoff
Antibiotics 2020, 9(10), 709; https://doi.org/10.3390/antibiotics9100709 - 17 Oct 2020
Cited by 20 | Viewed by 3849
Abstract
Changes were evaluated over 10 years in the in vitro resistance of human periodontopathic strains of Parvimonas micra to four antibiotics. Subgingival biofilms culture positive for P. micra from 300 United States adults with severe periodontitis in 2006, and from a similar group [...] Read more.
Changes were evaluated over 10 years in the in vitro resistance of human periodontopathic strains of Parvimonas micra to four antibiotics. Subgingival biofilms culture positive for P. micra from 300 United States adults with severe periodontitis in 2006, and from a similar group of 300 patients in 2016, were plated onto anaerobically incubated enriched Brucella blood agar alone, or supplemented with either doxycycline (4 mg/L), clindamycin (4 mg/L), amoxicillin (8 mg/L), or metronidazole (16 mg/L). P. micra growth on antibiotic-supplemented media indicated in vitro resistance to the evaluated antibiotic concentration. P. micra resistance was significantly more frequent among patients in 2016, as compared to 2006, for doxycycline (11.3% vs. 0.3% patients; 37.7-fold increase), and clindamycin (47.3% vs. 2.0% patients; 23.7-fold increase) (both p < 0.001), whereas resistance to amoxicillin (2.3% vs. 1.0% patients) and metronidazole (0% vs. 0.3% patients) remained low and statistically unchanged between the two patient groups (p-values > 0.05). No P. micra isolates in 2006 or 2016 were jointly resistant in vitro to both amoxicillin and metronidazole. The alarming increases in subgingival P. micra resistance to doxycycline and clindamycin raise serious questions about the empiric use of these antibiotics, either locally or systemically, in the treatment of United States periodontitis patients harboring subgingival P. micra. Full article
(This article belongs to the Special Issue Antibiotic Treatment of Oral Infections)

Review

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15 pages, 2879 KiB  
Review
A Local Desiccant Antimicrobial Agent as an Alternative to Adjunctive Antibiotics in the Treatment of Periodontitis: A Narrative Review
by Iulia C. Micu, Alexandrina Muntean, Alexandra Roman, Ștefan I. Stratul, Emöke Pall, Andreea Ciurea, Andrada Soancă, Marius Negucioiu, Lucian Barbu Tudoran and Ada G. Delean
Antibiotics 2023, 12(3), 456; https://doi.org/10.3390/antibiotics12030456 - 24 Feb 2023
Cited by 9 | Viewed by 2443
Abstract
Periodontitis is one of the most common oral polymicrobial infectious diseases induced by the complex interplay between the altered subgingival microbiota and the host’s dysregulated immune-inflammatory response, leading to the initiation of progressive and irreversible destruction of the periodontal tissues and eventually to [...] Read more.
Periodontitis is one of the most common oral polymicrobial infectious diseases induced by the complex interplay between the altered subgingival microbiota and the host’s dysregulated immune-inflammatory response, leading to the initiation of progressive and irreversible destruction of the periodontal tissues and eventually to tooth loss. The main goal of cause-related periodontal therapy is to eliminate the dysbiotic subgingival biofilm in order to arrest local inflammation and further periodontal tissue breakdown. Because, in some cases, subgingival mechanical instrumentation has limited efficiency in achieving those goals, various adjunctive therapies, mainly systemic and locally delivered antimicrobials, have been proposed to augment its effectiveness. However, most adjunctive antimicrobials carry side effects; therefore, their administration should be precociously considered. HybenX® (HY) is a commercial therapeutical agent with decontamination properties, which has been studied for its effects in treating various oral pathological conditions, including periodontitis. This review covers the current evidence regarding the treatment outcomes and limitations of conventional periodontal therapies and provides information based on the available experimental and clinical studies related to the HY mechanism of action and effects following its use associated with subgingival instrumentation and other types of dental treatments. Full article
(This article belongs to the Special Issue Antibiotic Treatment of Oral Infections)
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