What are the next steps for a patient with a dental abscess who has already been treated with Amoxicillin (amox) with minimal relief?

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

If amoxicillin hasn't provided adequate relief for your tooth abscess, you should contact your dentist or healthcare provider immediately for further evaluation, as they may need to prescribe a different antibiotic such as clindamycin or amoxicillin with clavulanic acid, which are more effective against resistant bacteria, as suggested by 1.

Key Considerations

• The most recent and highest quality study, 1, recommends clindamycin or a combination of penicillin and metronidazole as effective pharmaceutical regimens for severe odontogenic infections.
• Dental abscesses require complete treatment, including drainage of the abscess and removal of the source of infection, as antibiotics alone may not fully penetrate the infected area, as noted in 2.
• Pain management with over-the-counter medications like ibuprofen or acetaminophen, and warm salt water rinses, may also provide relief, as mentioned in the example answers.

Treatment Options

• Clindamycin (300-450mg every 6 hours) or amoxicillin with clavulanic acid (875/125mg twice daily) for 7-10 days may be prescribed, as suggested by 1 and the example answers.
• Dental procedures like root canal therapy or tooth extraction may be necessary to properly drain the abscess and remove the source of infection, as noted in 2.

Important Notes

• Antibiotic resistance is a growing concern, and the judicious use of antibiotics is crucial, as emphasized in 2 and 3.
• The choice of antibiotic should be based on the severity of the infection, the patient's medical history, and the likelihood of antibiotic resistance, as suggested by 1.