Microbiological profile and antibiotic resistance patterns in orofacial odontogenic space infections: A clinical study

Background: Orofacial odontogenic infections remain a significant clinical problem in oral and maxillofacial surgery. The emergence of antibiotic-resistant microorganisms has altered the microbiological profile of these infections and challenged empirical antibiotic therapy. Aim: This study aimed to identify the microorganisms responsible for odontogenic space infections and evaluate their antibiotic sensitivity and resistance patterns. Materials and Methods: A prospective observational study was conducted in the Department of Oral and Maxillofacial Surgery, CKS Theja Institute of Dental Sciences and Research, Tirupati, Andhra Pradesh. Thirty patients with clinically diagnosed odontogenic orofacial space infections were included in the study. Pus samples were collected aseptically and cultured aerobically on blood agar and MacConkey Agar media. Organisms were identified using Gram staining and biochemical tests. Antibiotic susceptibility testing was performed using the Kirby–Bauer disc diffusion method on Mueller–Hinton agar. Results: Among 30 patients, bacterial growth was observed in 28 (93.3%) cases. Staphylococcus aureus was the most commonly isolated organism (46.7%), followed by Escherichia coli (36.7%). The buccal space was the most commonly involved fascial space. Cefoperazone–sulbactam, netilmicin sulphate, and cefixime showed the highest sensitivity rates, whereas cephalexin, cefuroxime, and ofloxacin demonstrated high resistance. Conclusion: S. aureus was the predominant pathogen in odontogenic space infections. Cefoperazone–sulbactam and cefixime exhibited excellent antimicrobial activity, whereas resistance to commonly prescribed antibiotics was significant. Culture and sensitivity testing remain essential for effective management of odontogenic infections.