Abstract
Dental treatments involving mucosal surface or contaminated tissue commonly cause transient bacteremia. The latest chemoprophylactic regimen recommended by the American Heart Association for prevention of infective endocarditis, published in December 1990, shows that clindamycin is useful to patients allergic to penicillins and cefems. To our enquiry about why clindamycin is used, however, the AHA replied that the effect of this Burg was based on empirical evaluation and that they had no basic test data. On enquiring the manufacturer of this drug (Upjohn Pharmaceuticals Limited.), we found that they did not have basic test data, either.
The materials were limited to the microorganisms isolated from samples that were collected from closed abscesses caused by odontogenic infection at 12 institutions during treament with cefpodoxime proxetil from October 1990 to September 1991.
Samples were gathered from 93 patients and 221 strains were indentified. MICs were determined for three kinds of antimicrobial agents : clindamycin, cefaclor, an agent most commonly used in Japan, and amoxicillin which is most highly recommended by the AHA.
Compared on the basis of MIC90, clindamycin showed the lowest MIC of MIC90≤0.05μg/ml while MIC90 of amoxicillin was 0.2 μg/ml and that of cefaclor 6.25 μg/ml.
The MIC levels of clindamycin were lower than those of the two other agents. This suggests that clindamycin can be used for chemoprophylaxis in dentistry and oral surgery.
