Antibiotic Options

Antibiotics used to treat oral infections include:

  • Penicillin VK, 25-50 mg/kg/day, divided four times daily
    • Due to increasing beta-lactamase production of oral anaerobes, especially Prevotella and Fusobacterium spp, treatment failure with penicillin antibiotic monotherapy has been well documented. For ill or complicated patients, consider broader spectrum antibiotics at the outset.
  • Amoxicillin, 35-50 mg/kg/day, divided┬áthree times daily
  • Amoxicillin-clavulanate, 35-50 mg/kg/day of the amoxicillin component, divided three times daily

For penicillin allergic patients:

  • Clindamycin, 10-25 mg/kg/day, divided┬áthree times daily

For severe infections, consider broad spectrum agents:

  • Ampicillin-sulbactam
  • Cefotaxime
  • Piperacillin-tazobactam
  • Imipenem-cilastatin

References

Bahl R, Sandhu S, Singh K, Sahai N, Gupta M. Odontogenic infections: Microbiology and management. Contemp Clin Dent. Jul 2014; 5(3):307-11

Lopes DR, Peres MP, Levin AS. Randomized study of surgical prophylaxis in immunocompromised hosts. J Dent Res. 2011; 90(2):225.