Severe Odontogenic Infection Antibiotics — NDEB AFK MCQ

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ModeratePharmacologySevere Odontogenic Infection AntibioticsNDEB AFK

Which of the following is the recommended first-line systemic antimicrobial regimen for severe odontogenic infections with systemic involvement when the patient is not penicillin-allergic?

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Correct answer: B — Amoxicillin-clavulanate 875/125 mg BID or amoxicillin 500 mg TID plus metronidazole 500 mg TID

Explanation lettering: C = shown as B · D = shown as C · E = shown as D · B = shown as E

For severe odontogenic infections (spreading cellulitis, fascial space involvement, systemic signs), the combination of amoxicillin plus metronidazole provides broad-spectrum coverage of the polymicrobial oral flora (aerobic streptococci covered by amoxicillin; obligate anaerobes covered by metronidazole). Alternatively, amoxicillin-clavulanate provides similar coverage in a single drug. Source control (I&D, extraction, endodontic treatment) remains the cornerstone — antibiotics are adjunctive to definitive surgical management.

Reference: CDA – Antibiotic Prescribing for Dental Practitioners, 2019; Hupp – Contemporary Oral and Maxillofacial Surgery, 7th ed., 2019