Table 4: Typical Prescriptions for the Most Commonly Used Antibiotics in Treating Orofacial Infections Generic Name (Brand Name) Available Formulations Usual Adult Dosage Usual Pediatric Dosage Notes Amoxicillin (Amoxil, generics) • 250, 500, 875 mg tablets 20-90 mg/kg/d divided q8-12h
250-500 mg q8h or 500-875 mg q12h
Useful (as amoxicillin or amoxicillin/ clavulanate) in combination with metronidazole
• 250, 500 mg capsules • 125, 250 mg chewable tablets • 125 mg/5 mL oral solution • 200 mg/5 mL oral solution • 250 mg/5 mL oral solution • 400 mg/5 mL oral solution • 250, 500 mg tablets • 100 mg/5 mL oral solution • 200 mg/5 mL oral solution
in addition to scaling and root planing in the treatment of periodontitis associated with
the presence of Actinobacillus actinomycetemcomitans (AA).
Azithromycin (Zithromax, generics)
500 mg day 1, then 250 mg once daily × 4 days
5-10 mg/kg once daily × 4 days
Use with caution in patients with a history of cardiovascular disease.
Cephalexin (Keflex, generics)
• 250, 500, 750 mg capsules
250 mg-1 g q6-12h
25-100 mg/ kg/d divided q6-8h
In patients with a history of severe reactions (urticaria, angioedema, bronchospasm, anaphylaxis), the rate of reactions to cephalexin in patients with a history of penicillin allergy is about 10%. For patients with a history of a less-than-severe reaction to cephalexin, the rate is closer to 0.1%. Not recommended for routine use in children or adolescents <18 years old.
Ciprofloxacin (Cipro, generics)
• 100, 250, 500, 750 mg tablets • 250 mg/5 mL oral solution • 500 mg/5 mL oral solution • 250, 500 mg tablets • 500 mg extended- release (XL) tablets • 250 mg/5 mL oral solution • 500 mg/5 mL oral solution
250-750 mg q12h 10-20 mg/kg q12h
Clarithromycin (Biaxin, generics)
250-500 mg q12h 1,000 mg once a day
7.5 mg/kg q12h XL tablets are not for pediatric use
Use with caution in patients with a history of cardiovascular disease.
Clindamycin (Cleocin, generics)
• 75, 150, 300 mg capsules • 75 mg/5 mL oral solution
150-450 mg q6-8h
10 mg/kg q8h About 1% of clindamycin users develop pseudomembranous colitis. Symptoms may occur 2-9 days after initiation of therapy;
however, it has never occurred with the 1-dose regimen of clindamycin used to prevent bacterial endocarditis and may not be any more frequent than other commonly used antibiotics. Tetracyclines are not recommended for use during pregnancy or in children ≤18 years of age since they have been reported to cause enamel hypoplasia and permanent teeth discoloration. Specific low-dose formulation containing a subantimicrobial dosage is also available for use as an adjunct to scaling and root planing or for subgingival application. Take at least 2 hours before, or 6 hours after, the dose of a multivitamin that contains polyvalent cations (i.e., calcium, iron, magnesium, selenium, zinc).
Doxycycline (Vibramycin, generics)
• 50, 75, 100, 150 mg capsules • 25 mg/5 mL oral solution • 50 mg/5 mL oral syrup
100 mg q12h
2-4 mg/kg/d divided q12h
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Book Code: DFL3024
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