Template:ANUG Treatment: Difference between revisions

(Created page with "*Organisms involved are polymycrobial but often include Fusobacterium necrophorum, Treponema spp, Selenomonas, and Prevotella ===Uncomplicated Disease=== *Antibiotics **Amo...")
 
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*Organisms involved are polymycrobial but often include Fusobacterium necrophorum, Treponema spp, Selenomonas, and Prevotella
''Organisms involved are polymycrobial but often include Fusobacterium necrophorum, Treponema spp, Selenomonas, and Prevotella''


===Uncomplicated Disease===
===Uncomplicated Disease===
*Antibiotics
**[[Amoxicillin]] 250mg 3 x daily for 7 days and/or
**[[Metronidazole]] 250mg 3 x daily for 7 days<ref>Atout R. N. et al.  Managing Patients with Necrotizing Ulcerative Gingivitis. J Can Dent Assoc 2013;79:d46.  http://www.jcda.ca/article/d46. Accessed April 2015</ref>


===Complicated Disease===
*{{AntibioticDose|disease=Acute necrotizing ulcerative gingivitis|drug=Amoxicillin/Clavulanate|dose=875 mg PO two times daily|context=Uncomplicated}} AND
*Antibiotics
**{{AntibioticDose|disease=Acute necrotizing ulcerative gingivitis|drug=Metronidazole|dose=500mg PO three times daily x 7 days|context=Uncomplicated}} <ref>Atout R. N. et al. Managing Patients with Necrotizing Ulcerative Gingivitis. J Can Dent Assoc 2013;79:d46. http://www.jcda.ca/article/d46. Accessed April 2015</ref>
**[[Penicillin V]] 500mg PO q6 hours AND [[metronidazole]] 500mg PO q8 hours x 10 days '''or'''
'''OR'''
**[[Amoxicillin]] 500mg PO TID for 10d plus [[metronidazole]] 250mg PO TID for 10d '''or'''
*{{AntibioticDose|disease=Acute necrotizing ulcerative gingivitis|drug=Clindamycin|dose=300mg PO three times daily|context=Uncomplicated}} '''OR'''
**[[Amoxicillin-clavulanate]] 500mg/125mg PO TID or 875mg/125mg PO BID for 10d '''or'''
*{{AntibioticDose|disease=Acute necrotizing ulcerative gingivitis|drug=Doxycycline|dose=100 mg PO BID x 10 days|context=Uncomplicated}}<ref>Walker C. et al. Rationale for use of antibiotics in periodontics. J Periodontol. 2002. 73(1):1188-96</ref>
**[[Clindamycin]] 150-300mg PO TID for 10d '''or'''
*If allergic to penicillin, the use {{AntibioticDose|disease=Acute necrotizing ulcerative gingivitis|drug=Ciprofloxacin|dose=500mg twice daily|context=Penicillin Allergy}} AND metronidazole 500mg PO three times daily
**[[Doxycycline]] 100mg PO BID for 10d<ref>Stephen J. et al Acute Necrotizing Ulcerative Gingivitis Empiric Therapy. http://emedicine.medscape.com/article/2028117-overview. Accessed April 2015</ref>


===Additional===
===Additional Therapies for the immunocompromised===
*Oral Treatment
 
**Chlorhexidine 0.01% oral rinse BID
For patient with AIDS or immunocompromised with risk of oral candidal infection then add:
**Hydrogen peroxide swishing (cheap home remedy)
*[[Nystatin|Nystatin]] oral rinse four times daily x 14 days OR
*Pain
*{{AntibioticDose|disease=Acute necrotizing ulcerative gingivitis|drug=Fluconazole|dose=200mg PO daily x 14 days|context=Immunocompromised}}
**[[Ibuprofen]] 400-600mg 3 times daily
 
**Magic Mouthwash (multiple variations) - 300cc of 1:1:1 viscous lidocaine 2%, Maalox, [[diphenhydramine]] 12.5mg/5ml elixir
===Additional Therapies for all patients===
*[[HIV]]+
 
**In addition to antibiotic regimen consider an oral anti-fungal or [[nystatin]]
*Chlorhexidine 0.01% oral rinse BID
**[[Fluconazole]] 200mg PO daily for 14 days
*Hydrogen peroxide swishing (innexpensive home remedy)
*[[Ibuprofen|Ibuprofen]] 400-600mg 3 times daily for pain
**Magic Mouthwash (multiple variations) - 300cc of 1:1:1 viscous lidocaine 2%, Maalox, [[diphenhydramine|diphenhydramine]] 12.5mg/5ml elixir

Latest revision as of 02:54, 20 March 2026

Organisms involved are polymycrobial but often include Fusobacterium necrophorum, Treponema spp, Selenomonas, and Prevotella

Uncomplicated Disease

OR

  • Clindamycin 300mg PO three times daily OR
  • Doxycycline 100 mg PO BID x 10 days[2]
  • If allergic to penicillin, the use Ciprofloxacin 500mg twice daily AND metronidazole 500mg PO three times daily

Additional Therapies for the immunocompromised

For patient with AIDS or immunocompromised with risk of oral candidal infection then add:

Additional Therapies for all patients

  • Chlorhexidine 0.01% oral rinse BID
  • Hydrogen peroxide swishing (innexpensive home remedy)
  • Ibuprofen 400-600mg 3 times daily for pain
    • Magic Mouthwash (multiple variations) - 300cc of 1:1:1 viscous lidocaine 2%, Maalox, diphenhydramine 12.5mg/5ml elixir
  1. ↑ Atout R. N. et al. Managing Patients with Necrotizing Ulcerative Gingivitis. J Can Dent Assoc 2013;79:d46. http://www.jcda.ca/article/d46. Accessed April 2015
  2. ↑ Walker C. et al. Rationale for use of antibiotics in periodontics. J Periodontol. 2002. 73(1):1188-96
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