11 March 2024

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Antibiotic microresistance: a topic far from the solution

Massimo Gagliani

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The problem of antibiotic prescriptions is becoming increasingly relevant. We hear from many quarters that antibiotic resistance is emerging as a global public threat. Having established this, I thought it useful to bring you this recent German study which examines local antibiotic resistance in periodontal diseases.

It is a little-studied topic in the context of periodontal therapy and a group of Teutonic researchers saw fit to enlist a large group of volunteers who had periodontal problems on which to analyze what? Simple, investigate the diversity of antibiotic resistance genes of the components of the subgingival bacterial flora. Many are aware of the difficulties of sampling and the level of sophistication of the investigations to be conducted; however, after a short time the results were surprising.

A total of 19 antibiotic resistance genes belonging to six antibiotic classes were detected in the subgingival biofilm. Two thirds of the volunteers (n = 26/39) showed antibiotic resistance genes for at least one of the classes of antibiotics used for the treatment of acute or chronic periodontal disease: among them macrolides were the most represented class (21/39 patients ).

What do these data suggest?

There is a high prevalence of antibiotic resistance genes in the bacterial flora of periodontal pockets. Most obvious clinical consequence: we involuntarily carry out irrelevant prescriptions because we do not have specific tests to identify resistance.

One real fact remains: in the absence of clinically and economically manageable tests, we will continue to act blindly, certainly not out of guilt or carelessness, regretting our impotence in the face of so many diversities of the microbiological cosmos.

Source: https://aap.onlinelibrary.wiley.com/doi/10.1002/JPER.22-0696