Prevalence Of Antibiotic Resistence In Endodontic Infection In Peshawar

Abstract

Antibiotic resistance in endodontic infections is an emerging challenge in clinical dentistry, driven largely by inappropriate prescribing and the persistence of resistant pathogens in root canal systems. This study critically evaluates the prevalence of antibiotic prescription in endodontic practice, the microbiological profile of primary and persistent infections, and the resistance patterns of associated pathogens. The 50 endodontic patients were full filling inclusion and exlusion criteria were sampled. Their dental swabs were subjected to morphological and biochemical identification and then Antibiotic Susceptibility profiling. A total of 50 patients with endodontic infections were evaluated, most of them female (73.3%). The mean age was 44.9 years (22–72). Radiographs showed periradicular lesions in 53.9% of patients, all of whom were symptomatic, while two-thirds without lesions were asymptomatic, suggesting a strong link between lesions and clinical symptoms From samples, 26 microorganisms were isolated (24 bacteria, 2 yeasts). Gram-positive cocci dominated (65.4%), mainly Enterococcus (26.8%), with E. faecalis comprising 85.7% of this group. Most isolates were facultative anaerobes (88.5%). Patients with lesions often had polymicrobial infections (2–4 species) Antibiotic testing showed highest susceptibility to amoxicillin (48%), followed by clindamycin (40%), though resistance to clindamycin was also high (52%). Amoxicillin-clavulanic acid showed reduced efficacy. Gram-negative bacilli were fully susceptible to amoxicillin but resistant to clindamycin. Enterococcus, particularly E. faecalis, displayed marked resistance to clindamycin (85.7%).  Clostridium  showed  multidrug  resistance,  and  Bacteroides  lacked  full

susceptibility to any drug. These results underscore the need for culture-based antibiotic selection in endodontic infections.