Page 133 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

Infections of the jaws

Osteomyelitis of the jaws of dental For acute cases, start with: **Clindamycin 300mg-600mg PO/IV Bone debridement is advised
origin Phenoxymethylpenicillin (Pen V) q6h-q8h
250-500mg PO q6h* Culture and sensitivity is necessary
for chronic cases, start with surgical
PLUS/MINUS treatment first
Metronidazole 400mg PO q8h
Antibiotics only when causative
OR organisms are identified

**Benzylpenicillin 8-12MU IV q24h in **Duration of antibiotic therapy can
4-6 divided doses be 4-6 weeks depending on patient
response / microbiological clearance
PLUS/MINUS of the pathogen
Metronidazole 500mg IV q8h

Spreading infections and infections of fascial spaces (with/without systemic signs)

Oral administration:
Cellulitis ± abscess of dental origin Benzylpenicillin 8-12MU IV q24h in Amoxicillin 250-750mg PO q8h Empirical antibiotics are started
4-6 divided doses PLUS/MINUS
Surgical site infection & Metronidazole 400mg PO q8-12h Incision and drainage is advised
traumatic wound infection PLUS/MINUS
Metronidazole 500mg IV q8h OR
Amoxicillin/clavulanate 625mg PO
q8h.
OR
Amoxicillin/clavulanate 1.2gm IV q8h OR
Cefuroxime 250-500mg PO q12h

HPP AMG Oral/ Dental Infections 61