Antibiotics for acute orofacial infections.

By virtue of their activity against common and microbial pathogens, three antibiotic groups have real or potential application in the routine management of acute orofacial infections: beta-lactams (penicillins and cephalosporins), macrolides (erythromycin and congeners) and the lincosamides (clindamycin). The beta-lactam agents, principally the penicillins, remain drugs of choice. The macrolides have gained a resurgence in popularity due to their low toxicity, improved pharmacokinetics with azithromycin and clarithromycin, and the ability to penetrate into white blood cells to attack intracellular microorganisms. Clindamycin may be useful in penicillin-allergic patients and when directed by culture and sensitivity tests.