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Odontogenic Infections

Ashley Zeoli


  • Consist primarily of dental caries and periodontal disease (gingivitis and periodontitis) that can have local and systemic involvement
  • Streptococcus species, peptostreptococcus, Veillonella, diphtheroid >80% of infections


  • Associated w/ fever of unknown origin (fever > 3 weeks without etiology), bacteremia w/ seeding of heart valves and prosthetic devices
  • Periodontal abscess commonly encountered on wards


  • Obtain panorex, use CT for osseous structures
  • If needing additional assistance, consult OMFS


  • Pyogenic odontogenic infections: parenteral therapy is favored
    • Immunocompetent: unasyn 3g IV q6 hours (alternative is PCN G with metro)
    • Immunocompromised: zosyn 4.5g IV q6 OR cefepime 2g IV q12 + metro 500mg PO q8

Additional information

  • Who needs antimicrobial ppx prior to dental procedures?
    • Does the pt have a high-risk condition or implanted device?
      • Yes? is the pt undergoing invasive dental procedure (manipulation of gingival tissue, periapical region of teeth, extraction, abscess drainage, routine teeth cleaning?)
        • Yes? Use antimicrobial ppx: Amoxicillin 2g
      • No? no abx ppx needed