Dental Infection

Patient Population: Pediatric
Condition Major Pathogens  First Choice Therapy Alternative Therapy Comments
Dental infection Streptococci, oral anaerobes  

Amoxicillin 22.5 mg/kg/dose (max 875 mg/dose) enterally bid 

Inpatient with severe infection (plan to transition to enteral therapy upon improvement):  

Ampicillin-sulbactam (Unasyn) 50 mg ampicillin/kg/dose (max 2000 mg ampicillin/dose) IV q6h  

If insufficient response to first choice therapy

Change to Amoxicillin-clavulanate (Augmentin) 22.5 mg amoxicillin/kg/ dose (max 875 mg amoxicillin/dose) enterally bid  

Penicillin or cephalosporin allergy with higher risk for allergic reaction:  

10 mg/kg/dose (max 600 mg/dose) enterally tid  

Consult Dentistry 

*See guidance on Amoxicillin-Clavulanate maximum dosing and formulations 

Duration: 3-7 days, individualized for more complicated infections  

Pediatric Empiric Antimicrobial Therapy Guidelines

This is a subsection of the UCSF Benioff Children’s Hospitals Empiric Antimicrobial Therapy Guidelines, developed by the Pediatric Antimicrobial Stewardship Programs at each campus to inform initial selection of empiric antimicrobial therapy for children at the UCSF Benioff Children’s Hospitals and affiliated outpatient sites. 

These are guidelines only and not intended to replace clinical judgment. Modification of therapy may be indicated based on patient comorbidities, previous antibiotic therapy or infection history. Doses provided are usual doses but may require modification based on patient age or comorbid conditions. Refer to Pediatric Antimicrobial Dosing Guideline for further guidance on dosing in children, and Neonatal Dosing Guideline for infants < 1 month of age. Consult a pediatric pharmacist for individualized renal or hepatic dose adjustment. Durations provided are usual recommendations for patients who are responding appropriately to therapy. For additional guidance, please contact Pediatric Infectious Diseases (ID) or the Pediatric Antimicrobial Stewardship Program (ASP) at the campus where your patient is receiving care.  

For questions or feedback about these guidelines, please email primary content owners, Rachel Wattier, Pediatric ASP Medical Director at BCH SF and Prachi Singh, Pediatric ASP Medical Director at BCH OAK. 

The content of these guidelines was updated in July 2021. See Summary and Rationale for Changes (password login to Box needed) for detailed explanations of the content changes.