Concomitant Factors Leading to an Atypical Osteonecrosis of the Jaw in a Patient with Multiple Myeloma

Table 3

Anti-infective pharmacologic treatments*.

Treatment	Dose and schedule
Antibacterials
Penicillin VK	500 mg every 6 to 8 hours for 7 to 10 days and then every 12 hours for maintenance
Amoxicillin	500 mg every 8 hours for 7 to 10 days and then every 12 hours for maintenance
Patients with penicillin allergy
Clindamycin	150 to 300 mg every 6 hours
Vibramycin	100 mg every 24 hours
Erythromycin ethylsuccinate	400 mg every 8 hours
Azithromycin	500 mg PO × 1 on day 1; 250 mg oral every 6 hours on days 2 to 5
Antifungals^† (when required)
Nystatin oral suspension	5 to 15 mL every 6 hours or 100.000 IU/mL
Clotrimazole	10 mg every 8 hours and every 5 hours on days 7 to 10
Fluconazole	200 mg initially and then 100 mg every 24 hours
Antivirals^‡
Acyclovir	400 mg every 12 hours
Valacyclovir hydrochloride	500 mg to 2 g every 12 hours

†Other potential systemic antifungals include itraconazole or ketoconazole.
^‡Role of antivirals in the treatment of osteonecrosis of the jaw has not yet been established.
*Novartis (Basel, Switzerland), data on file.