Antibacterial activity of moxifloxacin against periodontal anaerobic pathogens involved in systemic infections
Introduction
Periodontal anaerobic pathogens are frequently associated with various infections, mainly systemic illnesses (bacteraemia, endocarditis, brain abscesses, urogenital infections and skin and soft tissue infections) [1], [2]. In particular, the spectrum of infections with Prevotella spp. and Porphyromonas spp., other than the periodontal ones, includes bacteraemia (mostly of oropharyngeal origin), head and neck infections (such as chronic otitis media, sinusitis and mastoiditis, peritonsillar and retro pharyngeal abscesses), pulmonary infections (as a result of aspiration), gastrointestinal and urogenital infections, and skin and soft tissue infections (especially around the oropharyngeal area) [3], [4], [5], [6], [7], [8], [9]. The different susceptibilities of these pathogens to antimicrobial agents makes therapy very difficult [10], [11], [12], [13]. Older fluoroquinolones have relatively poor activity against anaerobic pathogens but newer fluoroquinolones have more activity against these organisms.
Moxifloxacin is a new oral 8-methoxy-quinolone with a wide spectrum of activity; it is active against Gram-negative and multi-resistant Gram-positive bacteria, aerobic and anaerobic bacteria, and atypical micro-organisms [14], [15].
The aim of this study was to evaluate the antibacterial activity of moxifloxacin in comparison with other antibiotics against anaerobic pathogens involved in periodontal infections.
Section snippets
Bacterial strains
The strains tested were 158 recent clinical isolates collected from periodontal infections. The isolates comprised: Bacteroides forsythus (6), Porphyromonas gingivalis (35), Prevotella melaninogenica (11), Prevotella intermedia (9), Prevotella spp. (8), Fusobacterium nucleatum (20), Campylobacter rectus (4), Actinomyces spp. (35) and Peptostreptococcus spp. (30). The isolates were identified by conventional tests [16], [17].
Antibiotics
Standard antimicrobial powders included: moxifloxacin (Bayer AG),
Minimum inhibitory concentrations
MIC range, MIC50, MIC90 of moxifloxacin, penicillin, amoxycillin/clavulanate, cefoxitin, erythromycin, clindamycin, and metronidazole against 158 anaerobic and facultative periodontal bacteria are shown in Table 1. Susceptibility rates are also shown.
All the isolates were inhibited by a concentration of moxifloxacin⩽0.5 mg/l. B. forsythus and C. rectus were susceptible to the lowest concentration of moxifloxacin of all the species we tested having a MIC range of 0.06–0.12 mg/l. P. gingivalis,
Discussion
Our results show that moxifloxacin has a potent antibacterial activity against periodontal pathogens comparable with that of cefoxitin and amoxycillin/clavulanate, and higher than that of clindamycin, metronidazole, penicillin and erythromycin.
Several studies report data concerning the antimicrobial susceptibility of anaerobic bacteria but there is little information on the susceptibility of less commonly isolated species, mainly those causing severe odontogenic infections.
Recent studies
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