Bacteremia of dental origin and antimicrobial sensitivity following oral surgical procedures in children.

METHODS The prevalence and intensity of bacteremia of dental origin were examined in 207 children divided into four groups: a baseline with no surgical intervention (group I), after a single tooth extraction (group II), multiple tooth extraction (group III), and mucoperiosteal flap elevation (group IV). The bacterial isolates were grown using a broth culture (Bactec) and lysis centrifugation (Paediatric Isolator) techniques. Dental plaque deposits, gingivitis, spontaneous gingival bleeding and the presence/absence of a dental abscess were recorded and their relationship to bacteremia assessed. RESULTS The broth culture was positive for group I 11% of the time, group II for 43%, group III for 54%, and group IV for 43%. The Paediatric Isolator system was found to be a poor method for detecting bacteremia, having only one quarter the sensitivity of the broth culture technique. When organisms were isolated, the intensity of bacteremia ranged from 1 to 3400 colony forming units per milliliter (cfu/mL). Bacterial isolates were susceptible to most of the antibiotics recommended for antibiotic prophylaxis, but erythromycin, gentamycin, penicillin G, and teicoplanin were only 80% (or less) effective in their efficacy while chlorhexidine, amoxicillin, clindamycin, and vancomycin were between 92 and 100% effective. CONCLUSIONS The antibiotics commonly used for an oral and/or parenteral prophylaxis are likely to be effective on at least 80% of occasions with most of them effective on 100% of occasions.