From the Research
The treatment for Rothia dentocariosa bacteremia typically involves intravenous antibiotics, with penicillin or ampicillin being the first-line choices. For adults, a typical regimen would be intravenous penicillin G 2-4 million units every 4-6 hours or ampicillin 2g every 4-6 hours for 2-4 weeks, depending on the severity of infection and clinical response 1. For patients with penicillin allergies, alternatives include ceftriaxone 1-2g daily, vancomycin 15-20 mg/kg every 8-12 hours, or clindamycin 600-900mg every 8 hours.
Key Considerations
- Treatment duration should be individualized based on clinical improvement, with most uncomplicated cases requiring 2 weeks of therapy, while endocarditis or other metastatic infections may require 4-6 weeks 2, 3.
- Source control is essential, so identifying and addressing the primary source of infection (often dental, oral, or gastrointestinal) is crucial for successful treatment.
- Blood cultures should be repeated to confirm clearance of bacteremia.
- R. dentocariosa is generally susceptible to beta-lactams, but susceptibility testing should guide definitive therapy as resistance patterns can vary 4, 5.
Recent Evidence
The most recent study from 2019 1 supports the use of penicillin or ampicillin as the first-line treatment for Rothia dentocariosa bacteremia, highlighting the importance of individualized treatment duration and source control. This study also emphasizes the potential for R. dentocariosa to cause severe infections, including endocarditis and cerebral septic emboli, underscoring the need for prompt and effective treatment.