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/Clavulanate]] 875 mg PO two times daily AND
**[[Amoxicillin]] 250mg 3 x daily for 7 days and/or
**[[Metronidazole]] 500mg PO three times daily x 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> '''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>
*[[Clindamycin]] 300mg PO three times daily '''OR'''
*[[Doxycycline]] 100 mg PO BID x 10 days<ref>Walker C. et al. Rationale for use of antibiotics in periodontics. J Periodontol. 2002. 73(1):1188-96</ref>
*If allergic to penicillin, the use [[Ciprofloxacin 500mg twice daily AND metronidazole 500mg PO three times daily


===Complicated Disease===
===Additional Therapies for the immunocompromised===
*Antibiotics
For patient with AIDS or immunocompromised with risk of oral candidal infection then add:
**[[Penicillin V]] 500mg PO q6 hours AND [[metronidazole]] 500mg PO q8 hours x 10 days '''or'''
*[[Nystatin]] oral rinse four times daily x 14 days OR
**[[Amoxicillin]] 500mg PO TID for 10d plus [[metronidazole]] 250mg PO TID for 10d '''or'''
*[[Fluconazole] 200mg PO daily x 14 days
**[[Amoxicillin-clavulanate]] 500mg/125mg PO TID or 875mg/125mg PO BID for 10d '''or'''
**[[Clindamycin]] 150-300mg PO TID for 10d '''or'''
**[[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 all patients===
*Oral Treatment
*Chlorhexidine 0.01% oral rinse BID
**Chlorhexidine 0.01% oral rinse BID
*Hydrogen peroxide swishing (innexpensive home remedy)
**Hydrogen peroxide swishing (cheap home remedy)
*[[Ibuprofen]] 400-600mg 3 times daily for pain
*Pain
**[[Ibuprofen]] 400-600mg 3 times daily
**Magic Mouthwash (multiple variations) - 300cc of 1:1:1 viscous lidocaine 2%, Maalox, [[diphenhydramine]] 12.5mg/5ml elixir
**Magic Mouthwash (multiple variations) - 300cc of 1:1:1 viscous lidocaine 2%, Maalox, [[diphenhydramine]] 12.5mg/5ml elixir
*[[HIV]]+
**In addition to antibiotic regimen consider an oral anti-fungal or [[nystatin]]
**[[Fluconazole]] 200mg PO daily for 14 days

Revision as of 16:46, 18 January 2019

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

Uncomplicated Disease

Additional Therapies for the immunocompromised

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

  • Nystatin oral rinse four times daily x 14 days OR
  • [[Fluconazole] 200mg PO daily x 14 days

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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