MICROBIOLOGICAL PROFILE AND ANTIBIOTIC RESISTANCE PATTERNS OF ODONTOGENIC MAXILLOFACIAL SPACE INFECTIONS: A RETROSPECTIVE STUDY AT LADY READING HOSPITAL, PESHAWAR

Abstract

Objective: To determine the microbiological profile and antibiotic resistance patterns of odontogenic maxillofacial space infections (OMSIs) among patients presenting to Lady Reading Hospital (LRH), Peshawar, and to identify factors associated with antibiotic resistance.

Methodology: This retrospective observational study was conducted at the Department of Oral and Maxillofacial Surgery, Lady Reading Hospital, Peshawar, from January 2024 to March 2025. Medical records of 180 patients diagnosed with odontogenic maxillofacial space infections were reviewed. Data on demographics, clinical characteristics, microbiological isolates, and antibiotic susceptibility patterns were extracted. Descriptive statistics were computed, and inferential analyses including chi-square tests and logistic regression were performed using SPSS version 26. A p-value <0.05 was considered statistically significant.

Results: The mean age of patients was 45.1 ± 16.3 years, with a male predominance (n=112, 62.2%). Periapical abscess was the most common primary dental infection (n=108, 60%). Viridans streptococci were the most frequently isolated organisms (n=52, 39.7%), followed by Prevotella species (n=39, 29.8%) and Peptostreptococcus (n=24, 18.3%). Antibiotic susceptibility testing revealed that 77.8% of isolates were sensitive to co-amoxiclav, 74.4% to ceftriaxone, and 68.9% to clindamycin. Penicillin resistance was observed in 41.1% of isolates and erythromycin resistance in 35.6%. Prior antibiotic use was reported by 65.7% of patients and was significantly associated with resistance to penicillin (p=0.008) and erythromycin (p=0.012). Diabetes mellitus was present in 50.99% of patients and was significantly associated with multi-space involvement (p=0.004).

Conclusion: Odontogenic maxillofacial space infections at LRH Peshawar are predominantly polymicrobial, with Viridans streptococci and Prevotella species being the most common isolates. Antibiotic resistance to penicillin and erythromycin is substantial and significantly associated with prior unregulated antibiotic use. Co-amoxiclav and ceftriaxone remain effective empirical choices. Antimicrobial stewardship interventions are urgently needed.