Drug of choice to treat a dental abscess is:

• A. Pen VK
• B. Amoxicillin
• C. Clindamycin
• D. Metronidazole

Answer: (A)

Choosing an antibiotic for a dental abscess centers on using a drug that effectively targets the typical oral pathogens, reaches good levels in the infection site, and has a favorable safety profile. Penicillin VK fits these criteria well. It is highly active against the streptococci that commonly initiate odontogenic infections and against many of the anaerobic bacteria that accompany them. It penetrates well into gingival crevicular fluid and bone, so therapeutic concentrations reach the abscessed area. Its spectrum is narrow enough to minimize disruption of normal flora and reduce the risk of resistance, and it’s generally inexpensive and well tolerated. It’s also safe in pregnancy and suitable for most patients without penicillin allergies. In contexts where penicillin can’t be used, alternatives like clindamycin may be chosen, though they carry higher risks (such as C. difficile infection) and aren’t as first-line for a typical mixed dental infection. Metronidazole targets anaerobes and is sometimes added in certain cases, but it doesn’t reliably cover the facultative streptococci that often participate, so it isn’t the preferred single agent for a standard odontogenic abscess. Amoxicillin is another option with good absorption and broader coverage, but Penicillin VK remains the standard initial choice for a typical case due to its targeted effectiveness and safety.