Oral Health and Maxillofacial Research

ABSTRACT

Antibiotic resistance in odontogenic infections has become a critical challenge within dental and maxillofacial practice, compromising the effectiveness of established antimicrobial protocols. The inappropriate and excessive prescription of antibiotics, often administered empirically without microbiological confirmation, has facilitated the rise of multidrug-resistant oral pathogens, leading to increased morbidity, treatment failures, and higher healthcare costs. A targeted literature search was performed using PubMed, ScienceDirect, and Scopus, focusing on publications from 2010 to 2024. Keywords included “odontogenic infections,” “antibiotic resistance,” “oral microbiota,” and “antimicrobial stewardship.” Eligible studies were limited to human clinical research, systematic reviews, and meta-analyses; experimental and non-English studies were excluded. Key resistant pathogens identified include Streptococcus spp., methicillin-resistant Staphylococcus aureus (MRSA), Prevotella spp., and Fusobacterium spp., showing decreased susceptibility to penicillin, amoxicillin, and clindamycin. Resistance mechanisms involve β-lactamase production, efflux pumps, biofilm formation, and target modifications. Clinically, these patterns complicate management, requiring broader-spectrum or adjunctive therapies and increasing disease burden and costs. Antimicrobial stewardship initiatives have proven essential in optimizing antibiotic use and preserving efficacy. Limitations include the lack of standardized dental prescribing guidelines and insufficient resistance surveillance. Future research should emphasize rapid diagnostics and the development of novel therapeutics to improve infection management in dental practice. This review aims to provide dental professionals with an updated understanding of antibiotic resistance in odontogenic infections, emphasizing the importance of required antibiotic use and the potential of novel therapeutic approaches to mitigate resistance development.

KEYWORDS

1. Antibiotic resistance
2. Dental infections
3. Penicillin
4. Antimicrobial peptides
5. Odontogenic infections