The aim of the work was to develop an algorithm of anti-microbial chemotherapy for the perioperative prevention of local inflammatory complications.
To clarify the data on possible pathogens of postoperative local inflammatory complications, the authors conducted their own microbiological studies to determine the microbiome of an operating wound under the conditions of aerobic and anaerobic cultivation of inoculum with subsequent identification by a complex of morphological, cultural and biochemical properties. Periodontal pathogens were identified by PCR. The microbiome of the surgical wound was analyzed for conditionally clean wounds (group 1 — 61 patients after dental implantation surgery), infected (group 2-41 patients with a diagnosis of pericoronitis, difficult eruption of the wisdom tooth) and contaminated (group 3 — 42 patients after cystectomy, granulomectomy).
Based on the literature data and the results of our own research, an algorithm of antimicrobial chemotherapy (prevention) for outpatient operations in dental practice has been developed. The algorithm includes the most commonly used drugs by dentists, taking into account the microbiota of the postoperative wound, the sensitivity of pathogens to antibiotics, and the duration of treatment courses.
Relevance. According to modern concepts, virulent representatives of periodontal pathogenic bacteria are actively involved in the development of both periodontal pathology and various forms of odontogenic infection. The species diversity of these pathogens determines the need for a combined approach when choosing antimicrobial drugs.The aim of the work is to provide a microbiological substantiation of the use of a combined dosage form of ciprofloxacin and tinidazole for the treatment of periodontal and odontogenic infections based on the determination of the spectrum of action and the characteristics of the activity of the components.Materials and methods. Determination of the sensitivity of various strains of periodontal and odontogenic infection pathogens (P. intermedia, S. constellatus; S. sanguis, K. pneumoniae, S. aureus – MRSA) was carried out by the method of automated cultivation of strains with different concentrations of the tested drugs – ciprofloxacin and tinidazole.Results. Differences in the activity of the components of the combined preparation ciprofloxacin and tinidazole were found in terms of the sensitivity of strains of aerobic and anaerobic pathogens to them. Aerobic strains, including MRSA, were inhibited by ciprofloxacin in a low concentration range (6.25 μg / ml), but for some anaerobic strains the activity of ciprofloxacin was borderline (12.5 μg / ml). This confirmed the need to include tinidazole in the composition of the complex preparation.Conclusion. The combination of ciprofloxacin and tinidazole provides coverage of the full spectrum of periodontal and odontogenic infections and can be used as the agent of choice in the antimicrobial chemotherapy algorithm for head and neck infections.
In the article is justified the choice of drugs and the need to conduct antimicrobial chemotherapy for periodontitis. On the basis of literature data and their own studies, the authors proposed an algorithm for antimicrobial chemotherapy of periodontitis, prevention of local andgeneral complications during paradontological interventions in accordance with the AWaRe classification (WHO). Antibiotics are divided into drugs of the first and second empirical choices depending on the form of periodontitis.
The aim of the work was to develop an algorithm of anti-microbial chemotherapy for the perioperative prevention of local inflammatory complications.
To clarify the data on possible pathogens of postoperative local inflammatory complications, the authors conducted their own microbiological studies to determine the microbiome of an operating wound under the conditions of aerobic and anaerobic cultivation of inoculum with subsequent identification by a complex of morphological, cultural and biochemical properties. Periodontal pathogens were identified by PCR. The microbiome of the surgical wound was analyzed for conditionally clean wounds (group 1 — 61 patients after dental implantation surgery), infected (group 2-41 patients with a diagnosis of pericoronitis, difficult eruption of the wisdom tooth) and contaminated (group 3 — 42 patients after cystectomy, granulomectomy).
Based on the literature data and the results of our own research, an algorithm of antimicrobial chemotherapy (prevention) for outpatient operations in dental practice has been developed. The algorithm includes the most commonly used drugs by dentists, taking into account the microbiota of the postoperative wound, the sensitivity of pathogens to antibiotics, and the duration of treatment courses.
In the article substantiated the choice of antibacterial drugs for antimicrobial chemotherapy in acute and chronic odontogen rhinosynusitis. The algorithm of antimicrobial chemotherapy, prevention of complications of surgical interventions on sinuses and damage associated with sinus perforation in dental interventions is given in accordance with the WHO classification AWaRe (WHO). Antibiotics are divided into drugs of the first and second empirical choice, depending on the need for use.
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