P0789 - Empiric and Novel Chemotherapeutic Therapy with Combination Antibiotic Treatment in a Child with Facial Cellulitis Secondary to Odontogenic Abscess

Introduction: Abscesses, including ones of odontogenic origin, provide significant challenges to both patients and healthcare providers. Patients and providers both want infection resolution in the most time efficient way and with the least amount of morbidity possible.

Case Description: This paper reports on a patient with an odontogenic abscess with systemic involvement. Upon examination, the patient had significant cellulitis of the face, neck and oral involvement with risk for serious progression. The patient was admitted to the hospital, and along with surgical intervention started an innovative combination of antibiotic therapy of ampicillin / sulbactam and ceftriaxone that allowed for an efficient resolution and hospital discharge.

Discussion: The addition of ceftriaxone to the treatment regimen makes this case unique. The combination of two beta-lactam antibiotics was weighed against other treatment possibilities for the odontogenic based infection. However, due to the acute nature of the abscess and cellulitis the clinical judgement of the providers was used to treat the patient with the regimen of ampicillin / sulbactam and ceftriaxone.

Conclusion: This patient significantly benefited from the immediate start of the combination of an antibiotics regimen that allowed for fast resolution and discharge from the hospital. The use of ampicillin / sulbactam and ceftriaxone in this case was clearly beneficial in the management of a odontogenic abscess and resulting cellulitis. The collaboration and effective communication of pediatric providers from both pediatric dental and hospital specialists also greatly contributed to the successful resolution of this case.