From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
If Zithromax (azithromycin) has failed to treat a dental infection, alternative antibiotic options such as amoxicillin-clavulanate (Augmentin) 875/125 mg twice daily for 7-10 days should be considered immediately, as it provides broader coverage against the mixed aerobic and anaerobic bacteria typically found in dental infections 1. When considering alternative antibiotic options, it is essential to prioritize those that provide effective coverage against the bacteria commonly found in dental infections.
- Amoxicillin-clavulanate (Augmentin) is often the next best choice, as it provides broader coverage against the mixed aerobic and anaerobic bacteria typically found in dental infections.
- Alternatively, clindamycin 300-450 mg four times daily for 7 days is effective for patients with penicillin allergies and provides excellent coverage against oral anaerobes.
- For more severe infections, a combination of metronidazole 500 mg three times daily plus penicillin VK 500 mg four times daily for 7-10 days may be necessary. Dental infections that fail initial antibiotic therapy often require definitive treatment through dental procedures such as drainage, extraction, or root canal therapy, as antibiotics alone may not resolve infections in necrotic tissue or abscesses 1.
- Patients should seek immediate dental care while starting the new antibiotic regimen, stay well-hydrated, take over-the-counter pain relievers as needed, and return to a healthcare provider if symptoms worsen or include fever, significant swelling, or difficulty breathing or swallowing. It is crucial to note that the most recent and highest quality study 1 emphasizes the importance of comprehensive guidelines for antibiotic therapy in dentistry to reduce the complications of unnecessary antibiotic prescriptions, especially bacterial resistance.