Treatment of Prevotella Infections

First-Line Treatment Options

• The Infectious Diseases Society of America recommends amoxicillin-clavulanate as the first-line treatment for Prevotella infections due to its excellent activity against these anaerobic bacteria and low resistance rates 1, 2
• Metronidazole is highly effective against Prevotella with very low resistance rates (0-1.7%) 1

Alternative Treatment Options

• Clindamycin can be used as an alternative treatment option, but resistance rates of 10-36.4% have been reported 1
• Moxifloxacin can be used as monotherapy with good anaerobic coverage, though resistance rates of 16.3% have been reported 1

Treatment Based on Infection Site

• For skin and soft tissue infections with Prevotella, the first choice is amoxicillin-clavulanate 875/125 mg twice daily 1, 2
• For oral/dental infections with Prevotella, the first choice is amoxicillin-clavulanate 875/125 mg twice daily 1
• For intra-abdominal infections with Prevotella, the first choice is amoxicillin-clavulanate 875/125 mg twice daily (oral) or ampicillin-sulbactam 1.5-3.0 g every 6 hours (IV) 1, 4

Special Considerations

• The duration of therapy is typically 7-10 days for uncomplicated infections, but longer courses may be needed for severe or complicated infections 5
• Surgical drainage is an important adjunct to antibiotic therapy for abscesses containing Prevotella 6
• Clinical response should be evident within 48-72 hours, and alternative therapy should be considered if no improvement is seen 1