ANTIBIOTICS IN ODONTOGENIC INFECTION

Usually involves penicillin, erythromycin and metronidazole.

Mild

• Penicillin V orally, 500mg first dose then 250mg qid (5 days)
• Erythromycin orally, 500mg first dose then 250mg qid (5 days) in patients allergic to penicillin

Moderately severe

• Amoxicillin 500mg orally tds for 5-7 days +/- metronidazole 400mg orally tds for 7 days
• Clindamycin orally 300mg first dose then 100- 300mg qid for 5- 7 days for patients allergic to penicillin.

Severe

• Benzylpenicillin IV 1.2g first dose then 600mg every 6 hr + metronidazole IV 500mg every 8 hours for a few days till acute episode subsides.
• Clindamycin IV 600mg first dose then 300mg IV every 6hr for penicillin allergic patients
• +/- Gentamicin 80mg every 8 hours (monitor blood levels)

Dr George Chu BDSc MBBS
Ed. Dr. Derek Louey MBBS FACEM