An approach to oral infections and their management

Hull, Mark; Chow, Anthony W.

doi:10.1007/s11908-005-0019-8

Cited by 19 publications

(15 citation statements)

References 51 publications

(45 reference statements)

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“…Looking beyond individual management, the cumulative 1326 antibiotic days of treatment amongst the 110 participants in this study represents excessive exposure for a condition that is preventable and for which primary management entails dental intervention [9, 10, 25]. Despite little evidence supporting antibiotic therapy as management of most types of dental infections – a recent systematic review on the topic concluded the quality of available evidence is “very low” [26] - it is estimated that 8 to10% of all primary care antibiotic prescriptions are for treatment of dental infections [27, 28].…”

Section: Discussionmentioning

confidence: 99%

“…Definitive management of ADI requires dental intervention; generally tooth extraction or root canal treatment, and often hospitalization. Antibiotics may serve a limited temporizing role pre- and peri-intervention but are not definitive management alone [9, 10]. Between 2000 and 2008 ADI hospitalization in the United States increased by 41%, after adjustment for growth, resulting in 8191 admissions in 2008 with attributed healthcare costs exceeding $105 million [2, 11].…”

Section: Introductionmentioning

confidence: 99%

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Acute dental infections managed in an outpatient parenteral antibiotic program setting: prospective analysis and public health implications

et al. 2017

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BackgroundThe number of Acute Dental Infections (ADI) presenting for emergency department (ED) care are steadily increasing. Outpatient Parenteral Antibiotic Therapy (OPAT) programs are increasingly utilized as an alternative cost-effective approach to the management of serious infectious diseases but their role in the management of severe ADI is not established. This study aims to address this knowledge gap through evaluation of ADI referrals to a regional OPAT program in a large Canadian center.MethodsAll adult ED and OPAT program ADI referrals from four acute care adult hospitals in Calgary, Alberta, were quantified using ICD diagnosis codes in a regional reporting system. Citywide OPAT program referrals were prospectively enrolled over a five-month period from February to June 2014. Participants completed a questionnaire and OPAT medical records were reviewed upon completion of care.ResultsOf 704 adults presenting to acute care facilities with dental infections during the study period 343 (49%) were referred to OPAT for ADI treatment and 110 were included in the study. Participant mean age was 44 years, 55% were women, and a majority of participants had dental insurance (65%), had seen a dentist in the past six months (65%) and reported prior dental infections (77%), 36% reporting the current ADI as a recurrence. Median length of parenteral antibiotic therapy was 3 days, average total course of antibiotics was 15-days, with a cumulative 1326 antibiotic days over the study period. There was no difference in total duration of antibiotics between broad and narrow spectrum regimes. Conservative cost estimate of OPAT care was $120,096, a cost savings of $597,434 (83%) compared with hospitalization.ConclusionsADI represent a common preventable cause of recurrent morbidity. Although OPAT programs may offer short-term cost savings compared with hospitalization, risks associated with extended antibiotic exposures and delayed definitive dental management must also be gauged.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2303-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute dental infections managed in an outpatient parenteral antibiotic program setting: prospective analysis and public health implications

et al. 2017

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“…[5][6] Typical causative agents of mandibular osteomyelitis are those of the normal oral flora as well as bacteria known to cause dental caries and periodontal diseases. 7 Fungal causes of mandibular osteomyelitis are rare, and those caused by Blastomyces are not welldescribed in the literature.…”

Section: Discussionmentioning

confidence: 99%

Mandibular blastomycosis: A case report and review of the literature

Albarillo

Varma

MacLeod

2018

Germs

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Introduction Blastomycosis is an endemic mycosis in the United States known to primarily cause pneumonia. However, dissemination to different organs including the musculoskeletal system has been described. Case report We report a case of mandibular blastomycosis in a healthy patient with no evidence of lung involvement. A 28 year-old female presented with recurrent right mandibular osteomyelitis despite courses of antibiotics and surgical debridement. She eventually underwent right hemimandibulectomy. Budding yeasts visualized on Gomori Methenamine-Silver (GMS) and Periodic acid-Schiff (PAS) were morphologically consistent with Blastomyces dermatitidis, and intra-operative cultures showed growth of mold identified as B. dermatitidis by DNA probe. She was placed on a prolonged course of itraconazole with clinical improvement. We also reviewed the literature and found 5 cases of similar presentation which we briefly summarized in this present case report. Conclusion Blastomycosis should be considered in patients with recurrent or persistent mandibular osteomyelitis even in immunocompetent individuals.

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“…In fact, Hull 16 and Holmstrup 17 demonstrated that the oral cavity is the main route of entry of etiological agents in infectious endocarditis.…”

Section: Discussionmentioning

confidence: 99%

Doença periodontal em portadoras de valvopatia durante a gravidez: estudo clínico e microbiológico

Ávila¹,

Timerman²,

Romito³

et al. 2011

Arq. Bras. Cardiol.

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An approach to oral infections and their management

Cited by 19 publications

References 51 publications

Acute dental infections managed in an outpatient parenteral antibiotic program setting: prospective analysis and public health implications

Acute dental infections managed in an outpatient parenteral antibiotic program setting: prospective analysis and public health implications

Mandibular blastomycosis: A case report and review of the literature

Doença periodontal em portadoras de valvopatia durante a gravidez: estudo clínico e microbiológico

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