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


===Uncomplicated Disease===
===Uncomplicated Disease=== <!--T:2-->
*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===
<!--T:3-->
*Antibiotics
*[[Special:MyLanguage/Amoxicillin/Clavulanate|Amoxicillin/Clavulanate]] 875 mg PO two times daily AND
**[[Penicillin V]] 500mg PO q6 hours AND [[metronidazole]] 500mg PO q8 hours x 10 days '''or'''
**[[Special:MyLanguage/Metronidazole|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'''
**[[Amoxicillin]] 500mg PO TID for 10d plus [[metronidazole]] 250mg PO TID for 10d '''or'''
*[[Special:MyLanguage/Clindamycin|Clindamycin]] 300mg PO three times daily '''OR'''
**[[Amoxicillin-clavulanate]] 500mg/125mg PO TID or 875mg/125mg PO BID for 10d '''or'''
*[[Special:MyLanguage/Doxycycline|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>
**[[Clindamycin]] 150-300mg PO TID for 10d '''or'''
*If allergic to penicillin, the use [[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 500mg twice daily 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===
 
*Oral Treatment
===Additional Therapies for the immunocompromised=== <!--T:4-->
**Chlorhexidine 0.01% oral rinse BID
 
**Hydrogen peroxide swishing (cheap home remedy)
<!--T:5-->
*Pain
For patient with AIDS or immunocompromised with risk of oral candidal infection then add:
**[[Ibuprofen]] 400-600mg 3 times daily
*[[Special:MyLanguage/Nystatin|Nystatin]] oral rinse four times daily x 14 days OR
**Magic Mouthwash (multiple variations) - 300cc of 1:1:1 viscous lidocaine 2%, Maalox, [[diphenhydramine]] 12.5mg/5ml elixir
*[[Special:MyLanguage/Fluconazole|Fluconazole]] 200mg PO daily x 14 days
*[[HIV]]+
 
**In addition to antibiotic regimen consider an oral anti-fungal or [[nystatin]]
 
**[[Fluconazole]] 200mg PO daily for 14 days
===Additional Therapies for all patients=== <!--T:6-->
 
<!--T:7-->
*Chlorhexidine 0.01% oral rinse BID
*Hydrogen peroxide swishing (innexpensive home remedy)
*[[Special:MyLanguage/Ibuprofen|Ibuprofen]] 400-600mg 3 times daily for pain
**Magic Mouthwash (multiple variations) - 300cc of 1:1:1 viscous lidocaine 2%, Maalox, [[Special:MyLanguage/diphenhydramine|diphenhydramine]] 12.5mg/5ml elixir
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Latest revision as of 02:44, 18 January 2026

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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:


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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