https://sanduoc.

net/phac-do-dieu-tri-benh-
rang-ham-mat-benh-vien-rang-ham-mat-tp-hcm/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114004/

Irreversible pulpitis, necrotic pulps, and localized acute apical abscesses

 no need antibiotic in no systematic signs

Soft tissue swelling of endodontic origin (apical abscess/alveolar abscess)

 pyrexia in last 24h  antibiolic

Acute facial swelling of dental origin/facial cellulitis

IF abscess  Signs of systemic involvement and septicemia (e.g. fever, malaise, asymmetry, facial swelling,
lymphadenopathy, trismus, tachycardia, dysphagia, respiratory distress)

The antibiotic of choice is

1. amoxicillin (2–3 days, max 5 days)

 Children > 3 months and < 40 kg: 20–40 mg/kg/day in divided doses 8 hourly
 children > 40 kg: 250–500 mg 8 hourly
2. or phenoxymethyl penicillin (2–3 days, max 5 days):
 children <12 years: 25–50 mg/kg/day in divided doses 6 hourly and
 children ≥12 years: 250–500 mg 6 hourly.

Recommended antibiotic regimen for penicillin-allergic patient

 metronidazole (3 days): children 30/mg/kg/day in divided doses 6 hourly

 azithromycin: children > 6 months up to 16 years: 5–12 mg/kg daily for 3 days,
 clarithromycin (7 days):7.5 mg/kg 12 hourly. 

Dental trauma
Systemic antibiotics have been recommended as adjunctive therapy for avulsed permanent incisors with an open
or closed apex.
Tetracycline (doxycycline twice daily for 7 days). Trẻ em trên 8 tuổi uống 25 - 50 mg/kg thể trọng/ngày chia 2 - 4 lần.

Penicillin V or amoxicillin can be given as an alternative in patients under 12 years of age

Pediatric periodontal diseases

Dental plaque-induced gingivitis, eruption gingivitis, pubertal gingivitis, gingivitis related to mouth breathing,
and primary herpetic gingivostomatitis are managed by appropriate local therapeutic interventions including
professional oral hygiene and reinforcement of brushing twice daily for at least 2 min and no antibiotics should
be prescribed.
Patients diagnosed with aggressive periodontal disease (now periodontitis) may require
 antibiotic of choice for aggressive periodontitis
 amoxicillin (50 mg/kg/day)
 metronidazole 30 mg/kg/day 8 hourly for 7 days.
 Recommended antibiotic regimen for penicillin-allergic patient is
 azithromycin (3 days): 10 mg/kg daily or metronidazole.

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cephalosporins should not be used in an individual with a history of anaphylaxis, angioedema, or urticaria with penicillin or
ampicillin
Another concern that dentists have expressed involves patients who require prophylaxis but are already taking antibiotics
for another condition. In these cases, the AHA guidelines and 2021 AHA scientific statement for infective endocarditis 7,
9
 recommend that the dentist select an antibiotic from a different class than the one the patient is already taking. For
example, if the patient is taking amoxicillin, the dentist should select azithromycin or clarithromycin for prophylaxis.