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Cefazolin versus ampicillin/sulbactam as an empiric antibiosis in severe odontogenic neck infection descending from the lower jaw—retrospective analysis of 350 cases

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Abstract

Objectives

Odontogenic infections descending from the lower jaw may lead to severe health conditions. Commonly, a biphasic treatment of surgical drainage and antibiotic therapy is conducted. The choice of the administered empiric antibiotic agent remains debatable.

Material and methods

Retrospectively, we analyzed 350 medical records of patients who were consecutively treated with odontogenic infections descending from the lower jaw. All patients received surgical drainage and either cefazolin or ampicillin/sulbactam as empiric antibiosis. In particular, the number of secondary operations, infectious parameters, and length of in-hospital stay were investigated.

Results

The most frequently infected space was the perimandibular/buccal space for both groups followed by the submandibular space. Number of revision procedures, early recurrence, and length of stay presented no significant difference between both groups (p > 0.05). Inflammatory parameters (c-reactive protein, leukocytes) similarly decreased in both groups.

Conclusion

Cefazolin targets the majority of the pathogens detected in severe odontogenic neck infections descending from the lower jaw and reveals comparable results to AMP/S in regard to the inflammatory parameters and in-hospital stay.

Clinical relevance

Cefazolin is a feasible empiric antibiosis for odontogenic neck infections descending from the lower jaw if surgical drainage is performed.

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Author notes

  1. Johannes Buller and Matthias Kreppel contributed equally to this work.

Authors and Affiliations

  1. Department for Oral and Craniomaxillofacial and Plastic Surgery, University of Cologne, Kerpener Strasse 62, 50931, Cologne, Germany

    Matthias Zirk, Joachim E. Zoeller, Linda Ringendahl, Johannes Buller & Matthias Kreppel

  2. Department of Dermatology, University of Cologne, Cologne, Germany

    Franziska Peters

  3. Institute for Medical Microbiology, Immunology and Hygiene, University Hospital of Cologne, Cologne, Germany

    Franziska Peters

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  1. Matthias Zirk
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Correspondence to Matthias Zirk.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Local ethics board exempts this study from a specific ethic vote due to its pure retrospective nature.

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Zirk, M., Zoeller, J.E., Peters, F. et al. Cefazolin versus ampicillin/sulbactam as an empiric antibiosis in severe odontogenic neck infection descending from the lower jaw—retrospective analysis of 350 cases. Clin Oral Invest 25, 563–570 (2021). https://doi.org/10.1007/s00784-020-03492-1

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