Periodontal abscess
- If recurrent, consider referral or extraction.
- Surgical drainage of both the pocket and the pulp chamber must be considered when there is a combined periodontal-endodontic lesion.
First line therapy
Personal plaque/calculus control and professional debridement essential
Systemic symptoms +/- unresponsive to above
The role of antibiotics in the treatment of periodontal abscess is not established.
Paediatric
| Empiric Therapy | Dose/Duration |
|---|---|
| [ Amoxicillin | 40mg/kg/d PO div tid x 7 days |
| + | |
| Metronidazole] | 15-30mg/kg/d PO div bid x 7 days |
| or | |
| Amoxicillin-clavulanate |
4:1 - 40mg amox./kg/d PO div tid x 7 days 7:1 - 45mg amox./kg/d PO div bid x 7 days |
Penicillin/Amoxicillin allergy - Paediatric
| Empiric Therapy | |
|---|---|
| Clindamycin | 30mg/kg/d PO div qid x 7 days |
Adult
| Empiric Therapy | |
|---|---|
| [ Amoxicillin | 500mg PO tid x 7 days |
| + | |
| Metronidazole] | 500mg PO bid x 7 days |
| or | |
| Amoxicillin-clavulanate | 875mg PO bid x 7 days |
Penicillin/amoxicillin allergy
| Empiric Therapy | |
|---|---|
| [Cefuroxime axetil | 500mg PO bid x 7 days |
| or | |
| Cefuroxime | 750mg IV/IM IV q8h x 7 days |
| or | |
| Ceftriaxone] | 1g IV/IM daily x 7 days |
| + | |
| Metronidazole | 500mg IV/PO bid x 7 days |
Cefuroxime and ceftriaxone allergy
| Empiric Therapy | Dose/Duration |
|---|---|
| Levofloxacin | 750mg IV/PO daily x 7 days |
| + | |
| Metronidazole | 500mg IV/PO bid x 7 days |