From the FDA Drug Label
AMOXICILLIN capsules, for oral use AMOXICILLIN tablets, for oral use AMOXICILLIN for Oral Suspension ... INDICATIONS AND USAGE Amoxicillin is a penicillin-class antibacterial indicated for treatment of infections due to susceptible strains of designated microorganisms (1) Adults and Pediatric Patients (1) • Upper Respiratory Tract Infections of the Ear, Nose, and Throat • Infections of the Genitourinary Tract • Infections of the Skin and Skin Structure • Infections of the Lower Respiratory Tract ... DOSAGE AND ADMINISTRATION • In Adults, 750 to1750 mg/day in divided doses every 8 to12 hours. • In Pediatric Patients over 3 Months of Age, 20 to 45 mg/kg/day in divided doses every 8 to12 hours.
The recommended antibiotic treatment for a toothache suspected to be caused by a bacterial infection is amoxicillin. The dosage for adults is 750 to 1750 mg/day in divided doses every 8 to 12 hours, and for pediatric patients over 3 months of age, it is 20 to 45 mg/kg/day in divided doses every 8 to 12 hours 1.
- Key points:
- Amoxicillin is a penicillin-class antibacterial.
- It is indicated for treatment of infections due to susceptible strains of designated microorganisms.
- Dosage varies by age and weight.
- Important considerations:
- Reduce the dose in patients with severe renal impairment.
- Monitor for severe cutaneous adverse reactions and discontinue if rash progresses.
- Evaluate for Clostridiodes difficile-associated diarrhea if diarrhea occurs.
From the Research
Amoxicillin is the recommended first-line antibiotic treatment for toothaches suspected to be caused by bacterial infections, typically prescribed at 500 mg three times daily for 5-7 days. This recommendation is based on the most recent and highest quality study available, which suggests that amoxicillin is effective in treating dental infections and has a favorable safety profile 2. For patients with penicillin allergies, clindamycin (300 mg four times daily for 5-7 days) is an appropriate alternative. In more severe infections or cases with poor response to amoxicillin, amoxicillin with clavulanic acid (Augmentin) may be prescribed at 875/125 mg twice daily for 5-7 days.
Some key points to consider when prescribing antibiotics for toothaches include:
- The importance of completing the full course of antibiotics, even if symptoms improve, to ensure that the infection is fully cleared
- The need to take the medication with food to reduce stomach upset and stay hydrated
- The importance of seeking immediate dental care to address the underlying cause of the infection
- The use of pain management with over-the-counter medications like ibuprofen or acetaminophen to help manage discomfort while the antibiotics take effect
It's also important to note that antibiotics alone are not sufficient treatment for dental infections, and should be considered temporary measures to control infection while arranging definitive dental treatment such as drainage, root canal therapy, or tooth extraction 3. Additionally, the use of antibiotics should be guided by evidence-based clinical guidelines and should take into account the potential risks and benefits of treatment, including the risk of antibiotic resistance and adverse events 4.
Other antibiotics, such as azithromycin, may also be effective in treating dental infections, but amoxicillin remains the first-line treatment due to its efficacy, safety, and cost-effectiveness 5. Overall, the goal of antibiotic treatment for toothaches is to control the infection and prevent complications, while also promoting the use of evidence-based and responsible antibiotic prescribing practices.