Aetiopathogenesis and Treatment Evaluation of Odontogenic Cellulitis in the Maxillofacial Region: a Retrospective Study

Objectives: The increasing resistance of microorganisms that cause odontogenic cellulitis to empirically administered antibiotics increases the duration of hospitalization. The aim of this retrospective cohort study is to evaluate the latest data on maxillofacial odontogenic cellulitis in order to provide valuable information for optimizing the treatment of this pathology.

Material and Methods: The medical records of patients treated for maxillofacial odontogenic cellulitis at the Hospital of Lithuanian University of Health Sciences (Kauno klinikos), between 2018 and 2023 were analysed. Data on age, gender, general health status, duration of intensive care unit treatment, total duration of treatment, and complications were analysed. The results of the microbiological culture of the pus were used to analyse the primary pathogen, its resistance, and sensitivity to antibiotics and antibacterial treatment.

Results: The streptococcus group (41.4%) was the most common pathogen. The duration of treatment did not differ significantly between the different localizations of cellulitis. The most commonly used antibiotics were a combination of penicillin and metronidazole. The highest success rate (76.9%) was observed with empirically administered combinations of cephalosporins and metronidazole. Antibiotic therapy was changed in 33.3% of cases.

Conclusions: The most frequently detected pathogens - the streptococcus group - are characterized by a high sensitivity to penicillin and clindamycin as well as third-generation cephalosporins. The most effective empirical antibiotic therapy is a combination of cefazolin and metronidazole and cefuroxime and metronidazole. Diabetes mellitus, lung disease, alternating antibiotic therapy and complications prolong the duration of treatment.

J Oral Maxillofac Res 2025;16(3):e4

doi: 10.5037/jomr.2025.16304

Accepted for publication: 27 September 2025

Keywords: anti-bacterial agents; antibiotic resistance; cellulitis; intensive care units.