Bacteriology and management of orofacial infections in a Maxillofacial and Oral Surgery clinic, South Africa

Introduction: the widespread use of antibiotics in clinical medicine has contributed to a significant decline in the morbidity and mortality attributable to orofacial infection. however, there are indications of global variations in the microbiology, sensitivity to antibiotics and clinical outcomes, which have not been studied locally. Aim of the study: to investigate the bacteriology and antimicrobial sensitivity of microorganisms causing orofacial infections amongst patients attending a local Maxillofacial and Oral Surgery clinic, in order to inform an appropriate antibiotic therapy regimen. Methodology: Study design and setting: A retrospective record-based survey conducted at the Medunsa Oral health centre, Sefako Makgatho health Sciences University, South Africa Data collection: Demographic details, clinical information and laboratory data (identified microorganisms and antibiotic sensitivity), were acquired from files dating between March 2011 and June 2015. Results: In total 122 pathogens had been successfully cultured from 127 patient specimens. the profile of microorganisms was predominately aerobic, with Streptococcus viridans, coagulase negative staphylococcus and Staphylococcus aureus comprising the majority. All responded favourably to first line antibiotics. Penicillin, clindamycin and gentamycin were the most effective antimicrobials. Conclusion: Penicillin remains the drug of choice in treating orofacial infections. the current study discourages the indiscriminate use of metronidazole.