IMPACT OF AMOXICILLIN/CLAVULANATE AND CLINDAMYCIN RESISTANCE ON HOSPITAL OUTCOMES OF ODONTOGENIC INFECTIONS OF DEEP FACIAL SPACES: AN INTEGRATIVE REVIEW

Abstract

Introduction: Odontogenic infections may spread to deep facial spaces and require hospital treatment. In this setting, antimicrobial resistance may limit the effectiveness of empirical antibiotic therapy. Objective: To analyze the relationship between resistance to amoxicillin/clavulanate and clindamycin and clinical and hospital outcomes in patients with odontogenic infections of deep facial spaces. Materials and Methods: An integrative, descriptive, qualitative review was conducted in PubMed/MEDLINE, Scopus, Web of Science, and Embase. Studies published from 2021 to 2026 in Portuguese or English addressing antimicrobial resistance, susceptibility to the drugs of interest, and clinical or hospital consequences were considered. The analyzed file set contained 42 documents, corresponding to 40 distinct documents after duplicate identification. Results: Clindamycin resistance was higher than amoxicillin/clavulanate resistance in most hospital-based studies. Clindamycin resistance ranged from 25.8% to 38.9% in large series and from 34% to 47% in a study of deep head and neck infections, whereas amoxicillin/clavulanate resistance ranged from 4.9% to 6.9% in the main cohorts. However, the association between resistance and prolonged hospitalization was inconsistent. Conclusions: Clindamycin resistance is a recurrent and clinically relevant finding, whereas amoxicillin/clavulanate showed lower resistance rates in the analyzed studies. Management should prioritize source control, microbiological assessment when indicated, and adaptation of antimicrobial therapy to local susceptibility patterns.