Pediatric Guidelines: Head and Neck Infections - Dental Infection

ID consultation is recommended for head and neck infections occurring in immunocompromised patients, and for those with atypical features, chronic course, or lack of response to first line therapy. 
Condition Major Pathogens First Choice Therapy Alternative Therapy Comments
Dental infection Oral aerobes and anaerobes (including beta-lactamase-producing anaerobes) Amoxicillin-clavulanate (Augmentin) 22.5mg/kg/dose amoxicillin PO BID (max 875mg amoxicillin/dose)

Penicillin allergy:

Clindamycin 10mg/kg/dose PO TID (max 600mg/dose)

Patient should see a dentist

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. For additional guidance, please contact Pediatric Infectious Diseases (ID) or the Pediatric Antimicrobial Stewardship Program (ASP).