The purpose of this study was to investigate the aerobic and anaerobic
flora of periapical abscesses and evaluate their susceptibility to va
rious antibiotics. In 52 patients, with a diagnosis of periapical absc
esses,, pus cultures were taken. Forty-two aerobes and 122 anaerobes w
ere revealed, with 2 or more than 2 anaerobic strains isolated in 36 p
atients. Infections were purely aerobic in 6%, purely anaerobic in 17%
and mixed in 75%, while in 2% of the specimens there was no growth of
microorganisms, Among anaerobes, microorganisms from the Bacteroides
group (38.5%), Peptostreptococcus spp. (24.6%), Peptococcus spp. (13.9
%), and Fusobacterium spp. (4.1%), predominated in all cultures. Among
aerobes the most prevalent bacteria were streptococci (47.6%) followe
d by staphylococci (35.6%) while Enterobacteriaceae were isolated in 4
.8% of specimens. Selected susceptibility tests performed on several a
naerobic species revealed that nitroimidazole derivatives, chloramphen
icol and clindamycin retain their broad spectrum killing activity agai
nst anaerobes, followed by cefoxitin and moxalactam. Of the newer quin
olones, ofloxacin was the most effective. It is evident that the high
isolation rate of anaerobic bacteria should influence empiric therapeu
tic decisions.