What is the typical prescription for amoxicillin (Augmentin)/clavulanate for dental infections in Canada?

Amoxicillin/Clavulanate Prescription for Dental Infections in Canada

For dental infections in Canada, amoxicillin-clavulanate 875/125 mg twice daily for 5-7 days is the recommended prescription when beta-lactamase producing organisms are suspected or for more complex infections. 1, 2

First-Line Treatment Options

• Surgical intervention should be the primary treatment for dental infections, with antibiotics serving only as adjunctive therapy 3, 2
• For mild to moderate dental infections, amoxicillin 500 mg three times daily for 5-7 days is the standard first-line treatment 3, 1
• For more severe infections or when beta-lactamase producing organisms are suspected, amoxicillin-clavulanate 875/125 mg twice daily for 5-7 days is recommended 1, 2
• Clinical studies have demonstrated that amoxicillin-clavulanate is highly effective against the predominant bacteria causing orofacial infections 4

When to Use Amoxicillin/Clavulanate

• Amoxicillin-clavulanate should be used when:
  • There is inadequate response to amoxicillin alone 3, 2
  • Complex or severe infections are present 3
  • Infections extend into cervicofacial tissues 2
  • Beta-lactamase producing organisms are suspected 1
• Research shows amoxicillin-clavulanate produces significantly better pain and swelling reduction compared to amoxicillin alone following oral surgical interventions 5

Dosing Regimen

• The standard prescription is amoxicillin-clavulanate 875/125 mg twice daily for 5-7 days 1, 2
• Alternative dosing: amoxicillin-clavulanate 625 mg three times daily for 5-7 days 6
• Treatment duration should typically be limited to 5 days when possible, as longer courses are often unnecessary 3, 2
• Clinical studies have shown that a 5-day course is usually sufficient for most dental infections 7

Special Considerations

• For penicillin-allergic patients, clindamycin 300-400 mg three times daily is the recommended alternative 3, 1
• Antibiotics should only be prescribed when indicated and not for conditions requiring only surgical management 1, 2
• Patients with systemic involvement (fever, lymphadenopathy), immunocompromised status, diffuse swelling, or progressive infections particularly benefit from antibiotic therapy 3, 2

Common Pitfalls to Avoid

• Prescribing antibiotics without proper surgical intervention 3, 2
• Using prolonged antibiotic courses when not indicated (5 days is typically sufficient) 3, 2
• Prescribing antibiotics for conditions that require only surgical management 3, 1
• Relying solely on antibiotics while delaying necessary surgical intervention 1
• Using antibiotics for irreversible pulpitis, which does not benefit from antimicrobial therapy 1

Efficacy and Safety

• Clinical studies have demonstrated that amoxicillin-clavulanate has high efficacy against the predominant bacteria in orofacial infections 4
• Research shows amoxicillin-clavulanate achieves clinical success in approximately 88.2% of cases of acute odontogenic infections 7
• The safety profile is consistent with the known side effects, with most adverse events (raised liver enzymes, diarrhea, and headache) being mild to moderate in intensity 7