From the Guidelines
Amoxicillin is the first-line antibiotic for tooth infections, as recommended by recent guidelines. According to the most recent study 1, the first line antibiotic for a dental (tooth) infection is amoxicillin.
Key Points to Consider
- The dosage of amoxicillin is typically 500mg three times daily for 5-7 days, as supported by the study 1.
- For patients with penicillin allergies, alternatives such as clindamycin (300mg four times daily) or azithromycin (500mg on day one, then 250mg daily for 4 days) may be considered.
- In more severe infections or cases with high risk of treatment failure, amoxicillin with clavulanic acid (875/125mg twice daily) may be preferred, as it provides broader coverage against bacteria that produce beta-lactamase enzymes.
- It's essential to note that while antibiotics are necessary to treat the infection, they should be used in conjunction with proper dental care, such as root canal therapy or extraction of the tooth, as recommended by the guidelines 1.
- Patients should be advised to complete the full course of antibiotics, even if symptoms improve, and to seek immediate dental care to resolve the underlying dental issue.
- Additionally, patients should be encouraged to stay hydrated, take probiotics to reduce gastrointestinal side effects, and use pain management with over-the-counter analgesics like ibuprofen or acetaminophen to help with discomfort while the antibiotics take effect.
From the Research
First Line Antibiotic for Dental Infections
- The first line antibiotic for a dental (tooth) infection is penicillin V (phenoxymethyl penicillin) 2, or amoxicillin in some cases 3, 4.
- Penicillin V is considered safe, highly effective, and inexpensive 2.
- Amoxicillin is also effective and can be used as a first-line antibiotic, especially in cases where penicillin V is not suitable 3, 4.
Alternative Antibiotics
- For patients allergic to penicillin, erythromycin may be used for mild, acute odontogenic infections 2.
- Clindamycin can be used as an alternative therapy for penicillin-allergic patients, but its potential gastrointestinal toxicity should be considered 2, 5.
- Amoxicillin-clavulanic acid (Augmentin) may be used as an alternative to clindamycin in penicillin-allergic patients, as it has been shown to have a lower risk of treatment failure 5.
Specific Cases
- In cases of endodontic infections, amoxicillin may be used as the first-line antibiotic, followed by the addition of metronidazole if symptoms do not improve 4.
- In cases of periodontal infections, systemic antibiotics may be used in conjunction with scaling, root planning, and curettage of the infected root and gingiva 3.