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 three 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 three times daily

For severe infections, consider broad spectrum agents:

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

References

American Dental Association. Evidence-Based Clinical Practice Guideline on Antibiotic Use for the Urgent Management of Pulpal- and Periapical-Related Dental Pain and Intraoral Swelling: A Report from the American Dental Association. https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/antibiotic-use-for-dental-pain-and-swelling. Accessed June 22, 2024.