Management of Severe Odontogenic Infection with Acute Kidney Injury

Pharmacological Interventions

• Aminoglycosides and tetracyclines must be avoided in acute kidney injury due to nephrotoxicity, as recommended by the National Kidney Foundation 1
• NSAIDs should be avoided as they can worsen renal function and delay recovery, according to the American Society of Nephrology 1, 3, 4

Supportive Care

• Aggressive IV hydration is essential to address prerenal azotemia and support renal recovery, as suggested by the National Kidney Foundation 1
• Adequate pain control, such as topical oral anesthetics (viscous lidocaine), is essential to restore oral intake and facilitate eventual transition to oral antibiotics, as recommended by the American Dental Association 3

Monitoring and Expected Outcomes

• Close monitoring during the recovery phase is essential as patients remain vulnerable to re-injury from nephrotoxins, according to the National Kidney Foundation 1
• With appropriate IV antibiotics, source control, and supportive care, expect clinical improvement within 48-72 hours with stabilization or improvement in renal function, as suggested by the American Society of Nephrology 1