Table 3. Recommended Empiric Therapy of Selected Dental Infections

- Most dental infections are polymicrobial (aerobic & anaerobic bacteria). Normal oral flora consists of >500 bacterial species.

- The etiology of dental infections is multifactorial. Organisms that are part of the normal flora of the mouth (see Table 2) may be associated with dental infections.

- Local antibiotic therapy (+/- local delivery systems) is not routinely recommended as it offers no advantage over conventional mechanical debridement.

- The routine use of mouthwashes/rinses for infection control/occupational risk exposure is not recommended.

- NB: Prolonged use of chlorhexidine is NOT recommended as it may result in selection of antimicrobial resistant oral bacteria.

- For treatment of fungal/yeast infections of the oral cavity, see Recommended Empiric Therapy of Fungal Infections.

These are empiric antibiotic recommendations based on local susceptibility patterns, and need to restrict and rationalize antibiotic use. Antibiotics listed for each condition are not all inclusive, nor are they all approved by TPD for the listed indication. Choice of empiric antibiotic therapy should be based on the patient’s age, allergies, co-morbidities, and clinical condition, as well as cost and convenience of the dosage regimen. Empiric antibiotic therapy should be modified to narrower spectrum antibiotic(s) according to culture and susceptibility (C&S) results.