Dental Infection | Infectious Diseases Management Program at UCSF

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:  Clindamycin 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

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 