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===Epiglottitis=== | |||
*Epiglottitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> | |||
:*Pediatrics | |||
::*Preferred regimen (1): [[Cefotaxime]] 50 mg/kg IV q8h | |||
::*Preferred regimen (2): [[Ceftriaxone]] 50–75 mg/kg/day IV q12–24h {{and}} [[Vancomycin]] 10 mg/kg IV q6h | |||
::*Alternate regimen (1): [[Levofloxacin]] 500 mg IV q24h (or 8 mg/kg IV q12h) {{and}} [[Clindamycin]] 20–40 mg/kg/day IV q6–8h | |||
:*Adults | |||
::*Preferred regimen (1): [[Cefotaxime]] 2 g IV q4–8h | |||
::*Preferred regimen (2): [[Ceftriaxone]] 1–2 g/day IV q12–24h {{and}} [[Vancomycin]] 2 g/day IV q6–12h | |||
::*Alternate regimen (1): [[Levofloxacin]] 750 mg IV q24h {{and}} [[Clindamycin]] 600–1200 mg IV q6–12h | |||
{{ | ===Jugular vein phlebitis=== | ||
* | * '''Septic jugular thrombophlebitis (Lemierre's syndrome)'''<ref>{{cite book | last = Hall | first = Jesse | title = Principles of critical care | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071738811 }}</ref> | ||
:* | :* Causative pathogens | ||
::* Fusobacterium | |||
::* Viridans and other streptococci | |||
::* Staphylococcus | |||
::* Peptostreptococcus | |||
::* Bacteroides | |||
::* Other oral anaerobes | |||
:* Preferred regimen (immunocompetent host) (1): [[Penicillin G]] 2–4 MU IV q4–6h | |||
:* Preferred regimen (immunocompetent host) (2): [[Metronidazole]] 0.5 g IV q6h) | |||
:* Preferred regimen (immunocompetent host) (3): [[Ampicillin-Sulbactam]] 2 g IV q4h | |||
:* Preferred regimen (immunocompetent host) (4): [[Clindamycin]] 600 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h | |||
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h | |||
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h | |||
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (5): [[Imipenem]] 500 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (6): [[Gatifloxacin]] 400 mg IV q24h | |||
===Laryngitis=== | |||
* Antibiotic use is not associated with significant improvement of objective symptoms<ref name="Reveiz-2005">{{Cite journal | last1 = Reveiz | first1 = L. | last2 = Cardona | first2 = AF. | last3 = Ospina | first3 = EG. | title = Antibiotics for acute laryngitis in adults. | journal = Cochrane Database Syst Rev | volume = | issue = 1 | pages = CD004783 | month = | year = 2005 | doi = 10.1002/14651858.CD004783.pub2 | PMID = 15674965 }}</ref><ref name="Reveiz-2007">{{Cite journal | last1 = Reveiz | first1 = L. | last2 = Cardona | first2 = AF. | last3 = Ospina | first3 = EG. | title = Antibiotics for acute laryngitis in adults. | journal = Cochrane Database Syst Rev | volume = | issue = 2 | pages = CD004783 | month = | year = 2007 | doi = 10.1002/14651858.CD004783.pub3 | PMID = 17443555 }}</ref><ref name="Reveiz-2013">{{Cite journal | last1 = Reveiz | first1 = L. | last2 = Cardona | first2 = AF. | title = Antibiotics for acute laryngitis in adults. | journal = Cochrane Database Syst Rev | volume = 3 | issue = | pages = CD004783 | month = | year = 2013 | doi = 10.1002/14651858.CD004783.pub4 | PMID = 23543536 }}</ref> and is not indicated in the treatment of acute laryngitis.<ref name="Schwartz-2009">{{Cite journal | last1 = Schwartz | first1 = SR. | last2 = Cohen | first2 = SM. | last3 = Dailey | first3 = SH. | last4 = Rosenfeld | first4 = RM. | last5 = Deutsch | first5 = ES. | last6 = Gillespie | first6 = MB. | last7 = Granieri | first7 = E. | last8 = Hapner | first8 = ER. | last9 = Kimball | first9 = CE. | title = Clinical practice guideline: hoarseness (dysphonia). | journal = Otolaryngol Head Neck Surg | volume = 141 | issue = 3 Suppl 2 | pages = S1-S31 | month = Sep | year = 2009 | doi = 10.1016/j.otohns.2009.06.744 | PMID = 19729111 }}</ref> | |||
===Lemierre's syndrome=== | |||
* '''Septic jugular thrombophlebitis (Lemierre's syndrome)'''<ref>{{cite book | last = Hall | first = Jesse | title = Principles of critical care | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071738811 }}</ref> | |||
:* Causative pathogens | |||
::* Fusobacterium | |||
::* Viridans and other streptococci | |||
::* Staphylococcus | |||
::* Peptostreptococcus | |||
::* Bacteroides | |||
::* Other oral anaerobes | |||
:* Preferred regimen (immunocompetent host) (1): ([[Penicillin G]] 2–4 MU IV q4–6h {{and}} [[Metronidazole]] 0.5 g IV q6h) | |||
:* Preferred regimen (immunocompetent host) (2): [[Ampicillin-Sulbactam]] 2 g IV q4h | |||
:* Preferred regimen (immunocompetent host) (3): [[Clindamycin]] 600 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h | |||
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h | |||
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h | |||
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (5): [[Imipenem]] 500 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (6): [[Gatifloxacin]] 400 mg IV q24h | |||
===Ludwig's angina=== | |||
* '''Ludwig's angina'''<ref>{{cite book | last = Hall | first = Jesse | title = Principles of critical care | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071738811 }}</ref> | |||
:* Causative pathogens | |||
::* Viridans and other streptococci | |||
::* Peptostreptococcus | |||
::* Bacteroides | |||
::* Other oral anaerobes | |||
:* Preferred regimen (immunocompetent host) (1): ([[Penicillin G]] 2–4 MU IV q4–6h {{and}} [[Tobramycin]] 2 mg/kg IV q8h) | |||
:* Preferred regimen (immunocompetent host) (2): [[Ampicillin-Sulbactam]] 2 g IV q4h | |||
:* Preferred regimen (immunocompetent host) (3): [[Clindamycin]] 600 mg IV q6h | |||
:* Preferred regimen (immunocompetent host) (4): [[Doxycycline]] 200 mg IV q12h | |||
:* Preferred regimen (immunocompetent host) (5): [[Cefoxitin]] 2 g IV q6h | |||
:* Preferred regimen (immunocompetent host) (6): [[Cefotetan]] 2 g IV q12h | |||
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h | |||
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h | |||
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h | |||
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (5): [[Meropenem]] 1 g IV q8h | |||
:* Preferred regimen (immunocomppromised host) (6): [[Gatifloxacin]] 200 mg IV q24h | |||
===Parapharyngeal space infection=== | |||
* '''Parapharyngeal space infection'''<ref>{{cite book | last = Hall | first = Jesse | title = Principles of critical care | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071738811 }}</ref> | |||
:* Causative pathogens | |||
::* Viridans and other streptococci | |||
::* Staphylococcus | |||
::* Peptostreptococcus | |||
::* Bacteroides | |||
::* Other oral anaerobes | |||
:* Preferred regimen (immunocompetent host) (1): ([[Penicillin G]] 2–4 MU IV q4–6h {{and}} [[Metronidazole]] 0.5 g IV q6h) | |||
:* Preferred regimen (immunocompetent host) (2): [[Ampicillin-Sulbactam]] 2 g IV q4h | |||
:* Preferred regimen (immunocompetent host) (3): [[Clindamycin]] 600 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h | |||
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h | |||
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h | |||
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (5): [[Imipenem]] 500 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (6): [[Gatifloxacin]] 400 mg IV q24h | |||
===Pharyngitis, diphtheria=== | |||
*Diphtheria<ref>''The first version of this article was adapted from the [[Centers for Disease Control and Prevention|CDC]] document "Diphtheria - 1995 Case Definition" athttp://www.cdc.gov/epo/dphsi/casedef/diphtheria_current.htm. As a work of an agency of the U.S. Government without any other copyright notice it should be available as a public domain resource''.</ref> | |||
:*The CDC recommends either: | |||
::*Preferred regimen (1): [[Erythromycin]] (PO or by IV) for 14 days (40 mg/kg per day with a maximum of 2 g/d) | |||
::*Preferred regimen (2): [[Procaine penicillin G]] given IM for 14 days (300,000 U/d for patients weighing <10 kg and 600,000 U/d for those weighing >10 kg). | |||
:*Patients with allergies | |||
::*Preferred regimen (1): [[Penicillin G]] | |||
::*Preferred regimen (2): [[Erythromycin]] | |||
::*Preferred regimen (3): [[Eifampin]] | |||
::*Preferred regimen (4): [[Clindamycin]] | |||
===Pharyngitis, streptococcal=== | |||
*Pharyngitis <ref name="Thomas-2000">{{Cite journal | last1 = Thomas | first1 = M. | last2 = Del Mar | first2 = C. | last3 = Glasziou | first3 = P. | title = How effective are treatments other than antibiotics for acute sore throat? | journal = Br J Gen Pract | volume = 50 | issue = 459 | pages = 817-20 | month = Oct | year = 2000 | doi = | PMID = 11127175 }}</ref><ref name="Spinks-2013">{{Cite journal | last1 = Spinks | first1 = A. | last2 = Glasziou | first2 = PP. | last3 = Del Mar | first3 = CB. | title = Antibiotics for sore throat. | journal = Cochrane Database Syst Rev | volume = 11 | issue = | pages = CD000023 | month = | year = 2013 | doi = 10.1002/14651858.CD000023.pub4 | PMID = 24190439 }}</ref> | |||
:*Acute | |||
::*Children: | |||
*Preferred regimen: [[Pencillin V]] PO 250 mg twice daily or 3 times daily | |||
::*Adolescents and adults: | |||
*Preferred regimen (1): [[Pencillin V]] PO 250 mg 4 times daily or 500 mg twice daily for 10 days | |||
*Preferred regimen (2): [[Amoxicillin]] 50 mg/kg once daily (max = 1000 mg) alternate:25 mg/kg (max = 500 mg) twice daily for 10 days | |||
*Preferred regimen (3): [[Penicillin G|Benzathine Penicillin G]] I.M 27 kg: 600 000 U; ≥27 kg: 1 200 000 U 1 dose only | |||
*Preferred regimen (4): [[Cephalexin]] PO 20 mg/kg/dose twice daily (max = 500 mg/dose)for 10 days | |||
*Alternate regimen (1): [[Cefadroxil]] PO 30 mg/kg OD (max = 1 g) for 10 days | |||
*Alternate regimen (2): [[Clindamycin]] PO 7 mg/kg/dose 3 times daily (max = 300 mg/dose) for 10 days | |||
*Alternate regimen (3): [[Azithromycin]]PO 12 mg/kg once daily (max = 500 mg) for 5 days | |||
*Alternate regimen (4): [[Clarithromycin]] PO 7.5 mg/kg/dose twice daily (max = 250 mg/dose) for 10 days | |||
:*Chronic | |||
::*Preferred regimen (1): [[Clindamycin]] 20–30 mg/kg/d in 3 doses (max = 300 mg/dose) for 10 days | |||
::*Preferred regimen (2): [[Penicillin]] {{and}} [[Rifampin]]; Penicillin V: 50 mg/kg/d in 4 doses × 10 d (max = 2000 mg/d) ;rifampin: 20 mg/kg/d in 1 dose × last 4 d of treatment (max = 600 mg/d) for 10 days {{and}} [[Amoxicillin–clavulanate]] 40 mg amoxicillin/kg/d in 3 doses (max = 2000 mg amoxicillin/d) for 10 days | |||
::*Preferred regimen (3): [[Benzathine penicillin G]] IM 600 000 U for <27 kg and 1 200 000 U for ≥27 kg single dose {{and}} [[Rifampin]] PO 20 mg/kg/d in 2 doses (max = 600 mg/d) for 4 days | |||
===Sinusitis, Acute=== | |||
*Sinusitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> | |||
*Sinusitis (Pediatrics) | |||
:*Preferred Regimen (1): [[Amoxicillin]] 90 mg / kg / day PO divided q12h | |||
:*Preferred Regimen (2): [[Amoxicillin-clavulanate]] (extra strength) suspension, 90 mg / kg / day (based on Amox component), PO divided q12h for 10-14 days | |||
::*If non-type I hypersensitivity to penicillin : | |||
:::*Preferred regimen (1): [[Cefuroxime axetil]] 30 mg / kg / day PO divided q12h for 10-14 days | |||
:::*Alternate Regimen (1): [[Cefdinir]] 14 mg / kg / day PO divided q12-24h, max of 600 mg / day for 10-14 days | |||
:::*Alternate Regimen (2): [[Cefpodoxime]] 10 mg / kg / day PO divided q12h for 10-14 days | |||
*Sinusitis (Adults) | |||
:*Preferred Regimen (1): [[Amoxicillin]] 250-500 mg q8h or 500-875 mg q12h or extended-release tablet 775 mg once daily | |||
:*Preferred Regimen (2): [[Amoxicillin-clavulanate]] (extended release tabs) 1000 / 62.5 mg 2 tabs or 2000/125 mg 1 tab, PO q12h for 5-7 days | |||
:*Alternate Regimen | |||
::*If type 1 hypersensitivity to penicillin : | |||
:*Preferred regimen (1): [[Levofloxacin]] 750 mg PO once daily for 5-7 days | |||
:*Preferred regimen (2): [[Doxycycline]] 100 mg PO q12h for 5-7 days | |||
::*If type 2 hypersensitivity to penicillin : | |||
:*Preferred regimen (1): [[Cefdinir]] 600 mg / day divided q12h or q24h for 5-7 days | |||
:*Preferred regimen (2): [[Cefpodoxime]] 200 mg PO q12h for 5-7 days | |||
:*Preferred regimen (3): [[Cefuroxime axetil]] 500 mg PO q12h for 5-7 days | |||
===Sinusitis, Chronic=== | |||
*Sinusitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> | |||
*Sinusitis (Pediatrics) | |||
:*Preferred Regimen:[[Amoxicillin-clavulanate]] 45 mg/kg per day q12h | |||
:*If penicillin allergy and patient is MRSA positive | |||
::*[[Clindamycin]] 20 to 40 mg/kg per day orally divided every 6 to 8 hours | |||
:*If anaerobes are involved | |||
::*[[Metronidazole]] PLUS one of the following: [[cefuroxime axetil]], [[cefdinir]], [[cefpodoxime proxetil]],[[azithromycin]], [[clarithromycin]], or [[trimethoprim-sulfamethoxazole]] (TMP-SMX) | |||
*Sinusitis (Adults) | |||
:*Preferred regimen (1): [[Amoxicillin-clavulanate]] 500 mg three times daily | |||
:*Preferred regimen (2): [[Amoxicillin-clavulanate]] 875 mg twice daily | |||
:*Preferred regimen (3): [[Amoxicillin-clavulanate]] two 1000 mg extended-release tablets twice daily) | |||
:*If penicillin allergy and patient is MRSA positive | |||
:*Preferred regimen (1): [[Clindamycin]] 300 mg four times daily or 450 mg three times daily) | |||
:*If anaerobes are involved | |||
:*Preferred regimen (1):[[Metronidazole]] {{and}} one of the following: [[cefuroxime axetil]], [[cefdinir]], [[cefpodoxime proxetil]], [[levofloxacin]] , [[azithromycin]], [[clarithromycin]] | |||
:*Preferred regimen (2): [[trimethoprim-sulfamethoxazole]] (TMP-SMX) | |||
:*Alternate regimen: [[Moxifloxacin ]](400 mg once daily) | |||
===Sinusitis, post-intubation=== | |||
*Sinusitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> | |||
:*Preferred regimen (1): [[Imipenem]] 0.5 gm IV q6h | |||
:*Preferred regimen (2): [[Meropenem]] 1 gm IV q8h, MRSA suggestive on Gram - stain then add [[Vancomycin]] 1 gm IV q12h | |||
:*Alternate Regimen (1): [[Ceftazidime]] 2 gm IV q8h {{and}} [[Vancomycin]] 1 gm IV q12h) | |||
:*Alternate Regimen (2): [[Cefepime]] 2 gm IV q12h {{and}} [[Vancomycin]] 1 gm IV q12h) | |||
===Sinusitis, treatment failure=== | |||
*Sinusitis (Pediatrics) <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> | |||
:*If treatment failure then do a culture and treat accordingly or treatment in the absence of cultures and children failing [[Amoxicillin]] | |||
::*[[Amoxicillin-clavulanate]] (extra strength) suspension 90 mg/kg/day (Amoxicllin component) PO divided q12h for 10-14 days. | |||
:*Treatment in the absence of cultures and children failing [[Amoxicillin-clavulanate]] | |||
::*[[Clindamycin]] 30-40 mg/kg/day divided q8h {{and}} third generation [[cephalosporin]] like [[Cefuroxime axetil]] 30 mg/kg/day PO divided q12h | |||
Preferred regimen (1): [[Cefdinir]] 14 mg/kg/day PO divided q12h or q24h | |||
Preferred regimen (2):[[Cefpodoxime]] 10 mg/kg/day PO divided q12h | |||
*Sinusitis (Adults) | |||
:*If failure of treatment even after 7 days of diagnosis | |||
Preferred regimen (1): [[Amoxicillin-clavulanate]] 4g per day of amoxicillin equivalent | |||
Preferred regimen (2): [[Levofloxacin]] 500 mg PO once daily | |||
Preferred regimen (3): [[Moxifloxacin]]400 mg PO once daily | |||
===Stomatitis, aphthous=== | |||
*Stomatitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> | |||
:*[[Topical steroids]] may decrease pain and swelling | |||
===Stomatitis, herpetic=== | |||
*Stomatitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> | |||
:*[[Acyclovir]] 15 mg/kg PO q5h For 7 days | |||
===Submandibular space infection=== | |||
* '''Submandibular space infections including Ludwig angina'''<ref>{{cite book | last = Hall | first = Jesse | title = Principles of critical care | publisher = McGraw-Hill Education | location = New York | year = 2015 | isbn = 978-0071738811 }}</ref> | |||
:* Causative pathogens | |||
::* Viridans and other streptococci | |||
::* Peptostreptococcus | |||
::* Bacteroides | |||
::* Other oral anaerobes | |||
:* Preferred regimen (immunocompetent host) (1): [[Penicillin G]] 2–4 MU IV q4–6h {{and}} [[Tobramycin]] 2 mg/kg IV q8h) | |||
:* Preferred regimen (immunocompetent host) (2): [[Ampicillin-Sulbactam]] 2 g IV q4h | |||
:* Preferred regimen (immunocompetent host) (3): [[Clindamycin]] 600 mg IV q6h | |||
:* Preferred regimen (immunocompetent host) (4): [[Doxycycline]] 200 mg IV q12h | |||
:* Preferred regimen (immunocompetent host) (5): [[Cefoxitin]] 2 g IV q6h | |||
:* Preferred regimen (immunocompetent host) (6): [[Cefotetan]] 2 g IV q12h | |||
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h | |||
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h | |||
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h | |||
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h | |||
:* Preferred regimen (immunocomppromised host) (5): [[Meropenem]] 1 g IV q8h | |||
:* Preferred regimen (immunocomppromised host) (6): [[Gatifloxacin]] 200 mg IV q24h | |||
===Tonsillitis=== | |||
*Tonsillitis <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> | |||
:*Preferred regimen:[[Penicillin V]] PO 10 days or if compliance unlikely, [[Benzathine penicillin]] IM single dose | |||
:*Alternate regimen (1): [[Cephalosporins|2nd generation Cephalosporins]] PO for 4–6 days | |||
:*Alternate regimen (2): [[Clindamycin]] or [[azithromycin]] for 5 days | |||
:*Alternate regimen (3): [[Clarithromycin]] for 10 days | |||
:*Alternate regimen (4): [[Erythromycin]] for 10 days. Extended-release [[amoxicillin]] is another (expensive) option | |||
===Ulcerative gingivitis=== | |||
*Provide patient with specific oral hygiene instructions to use a prescription antibacterial mouthwash: [[Chlorhexidine]] 0.12% twice daily.<ref>{{Cite web | title =Managing Patients with Necrotizing Ulcerative Gingivitis | |||
| url = http://www.jcda.ca/article/d46}}</ref> | |||
*For any signs of systemic involvement, the recommended antibiotics are: | |||
:*Preferred regimen: [[Amoxicillin]], 250 mg 3 x daily for 7 days {{withorwithout}} [[Metronidazole]], 250 mg 3 x daily for 7 days | |||
===Vincent's angina=== | |||
*Vincent's angina <ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref> | |||
:*Preferred treatment:[[Penicillin G]] 4 million units IV q4h | |||
:*Alternate treatment: [[Clindamycin]] 600 mg IV q8h | |||
{{reflist}} | {{reflist}} |
Latest revision as of 18:00, 30 July 2015
Epiglottitis
- Epiglottitis [1]
- Pediatrics
- Preferred regimen (1): Cefotaxime 50 mg/kg IV q8h
- Preferred regimen (2): Ceftriaxone 50–75 mg/kg/day IV q12–24h AND Vancomycin 10 mg/kg IV q6h
- Alternate regimen (1): Levofloxacin 500 mg IV q24h (or 8 mg/kg IV q12h) AND Clindamycin 20–40 mg/kg/day IV q6–8h
- Adults
- Preferred regimen (1): Cefotaxime 2 g IV q4–8h
- Preferred regimen (2): Ceftriaxone 1–2 g/day IV q12–24h AND Vancomycin 2 g/day IV q6–12h
- Alternate regimen (1): Levofloxacin 750 mg IV q24h AND Clindamycin 600–1200 mg IV q6–12h
Jugular vein phlebitis
- Septic jugular thrombophlebitis (Lemierre's syndrome)[2]
- Causative pathogens
- Fusobacterium
- Viridans and other streptococci
- Staphylococcus
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host) (1): Penicillin G 2–4 MU IV q4–6h
- Preferred regimen (immunocompetent host) (2): Metronidazole 0.5 g IV q6h)
- Preferred regimen (immunocompetent host) (3): Ampicillin-Sulbactam 2 g IV q4h
- Preferred regimen (immunocompetent host) (4): Clindamycin 600 mg IV q6h
- Preferred regimen (immunocomppromised host) (1): Cefotaxime 2 g IV q6h
- Preferred regimen (immunocomppromised host) (2): Ceftizoxime 4 g IV q8h
- Preferred regimen (immunocomppromised host) (3): Piperacillin 3 g IV q4h
- Preferred regimen (immunocomppromised host) (4): Imipenem 500 mg IV q6h
- Preferred regimen (immunocomppromised host) (5): Imipenem 500 mg IV q6h
- Preferred regimen (immunocomppromised host) (6): Gatifloxacin 400 mg IV q24h
Laryngitis
- Antibiotic use is not associated with significant improvement of objective symptoms[3][4][5] and is not indicated in the treatment of acute laryngitis.[6]
Lemierre's syndrome
- Septic jugular thrombophlebitis (Lemierre's syndrome)[7]
- Causative pathogens
- Fusobacterium
- Viridans and other streptococci
- Staphylococcus
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host) (1): (Penicillin G 2–4 MU IV q4–6h AND Metronidazole 0.5 g IV q6h)
- Preferred regimen (immunocompetent host) (2): Ampicillin-Sulbactam 2 g IV q4h
- Preferred regimen (immunocompetent host) (3): Clindamycin 600 mg IV q6h
- Preferred regimen (immunocomppromised host) (1): Cefotaxime 2 g IV q6h
- Preferred regimen (immunocomppromised host) (2): Ceftizoxime 4 g IV q8h
- Preferred regimen (immunocomppromised host) (3): Piperacillin 3 g IV q4h
- Preferred regimen (immunocomppromised host) (4): Imipenem 500 mg IV q6h
- Preferred regimen (immunocomppromised host) (5): Imipenem 500 mg IV q6h
- Preferred regimen (immunocomppromised host) (6): Gatifloxacin 400 mg IV q24h
Ludwig's angina
- Ludwig's angina[8]
- Causative pathogens
- Viridans and other streptococci
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host) (1): (Penicillin G 2–4 MU IV q4–6h AND Tobramycin 2 mg/kg IV q8h)
- Preferred regimen (immunocompetent host) (2): Ampicillin-Sulbactam 2 g IV q4h
- Preferred regimen (immunocompetent host) (3): Clindamycin 600 mg IV q6h
- Preferred regimen (immunocompetent host) (4): Doxycycline 200 mg IV q12h
- Preferred regimen (immunocompetent host) (5): Cefoxitin 2 g IV q6h
- Preferred regimen (immunocompetent host) (6): Cefotetan 2 g IV q12h
- Preferred regimen (immunocomppromised host) (1): Cefotaxime 2 g IV q6h
- Preferred regimen (immunocomppromised host) (2): Ceftizoxime 4 g IV q8h
- Preferred regimen (immunocomppromised host) (3): Piperacillin 3 g IV q4h
- Preferred regimen (immunocomppromised host) (4): Imipenem 500 mg IV q6h
- Preferred regimen (immunocomppromised host) (5): Meropenem 1 g IV q8h
- Preferred regimen (immunocomppromised host) (6): Gatifloxacin 200 mg IV q24h
Parapharyngeal space infection
- Parapharyngeal space infection[9]
- Causative pathogens
- Viridans and other streptococci
- Staphylococcus
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host) (1): (Penicillin G 2–4 MU IV q4–6h AND Metronidazole 0.5 g IV q6h)
- Preferred regimen (immunocompetent host) (2): Ampicillin-Sulbactam 2 g IV q4h
- Preferred regimen (immunocompetent host) (3): Clindamycin 600 mg IV q6h
- Preferred regimen (immunocomppromised host) (1): Cefotaxime 2 g IV q6h
- Preferred regimen (immunocomppromised host) (2): Ceftizoxime 4 g IV q8h
- Preferred regimen (immunocomppromised host) (3): Piperacillin 3 g IV q4h
- Preferred regimen (immunocomppromised host) (4): Imipenem 500 mg IV q6h
- Preferred regimen (immunocomppromised host) (5): Imipenem 500 mg IV q6h
- Preferred regimen (immunocomppromised host) (6): Gatifloxacin 400 mg IV q24h
Pharyngitis, diphtheria
- Diphtheria[10]
- The CDC recommends either:
- Preferred regimen (1): Erythromycin (PO or by IV) for 14 days (40 mg/kg per day with a maximum of 2 g/d)
- Preferred regimen (2): Procaine penicillin G given IM for 14 days (300,000 U/d for patients weighing <10 kg and 600,000 U/d for those weighing >10 kg).
- Patients with allergies
- Preferred regimen (1): Penicillin G
- Preferred regimen (2): Erythromycin
- Preferred regimen (3): Eifampin
- Preferred regimen (4): Clindamycin
Pharyngitis, streptococcal
- Acute
- Children:
- Preferred regimen: Pencillin V PO 250 mg twice daily or 3 times daily
- Adolescents and adults:
- Preferred regimen (1): Pencillin V PO 250 mg 4 times daily or 500 mg twice daily for 10 days
- Preferred regimen (2): Amoxicillin 50 mg/kg once daily (max = 1000 mg) alternate:25 mg/kg (max = 500 mg) twice daily for 10 days
- Preferred regimen (3): Benzathine Penicillin G I.M 27 kg: 600 000 U; ≥27 kg: 1 200 000 U 1 dose only
- Preferred regimen (4): Cephalexin PO 20 mg/kg/dose twice daily (max = 500 mg/dose)for 10 days
- Alternate regimen (1): Cefadroxil PO 30 mg/kg OD (max = 1 g) for 10 days
- Alternate regimen (2): Clindamycin PO 7 mg/kg/dose 3 times daily (max = 300 mg/dose) for 10 days
- Alternate regimen (3): AzithromycinPO 12 mg/kg once daily (max = 500 mg) for 5 days
- Alternate regimen (4): Clarithromycin PO 7.5 mg/kg/dose twice daily (max = 250 mg/dose) for 10 days
- Chronic
- Preferred regimen (1): Clindamycin 20–30 mg/kg/d in 3 doses (max = 300 mg/dose) for 10 days
- Preferred regimen (2): Penicillin AND Rifampin; Penicillin V: 50 mg/kg/d in 4 doses × 10 d (max = 2000 mg/d) ;rifampin: 20 mg/kg/d in 1 dose × last 4 d of treatment (max = 600 mg/d) for 10 days AND Amoxicillin–clavulanate 40 mg amoxicillin/kg/d in 3 doses (max = 2000 mg amoxicillin/d) for 10 days
- Preferred regimen (3): Benzathine penicillin G IM 600 000 U for <27 kg and 1 200 000 U for ≥27 kg single dose AND Rifampin PO 20 mg/kg/d in 2 doses (max = 600 mg/d) for 4 days
Sinusitis, Acute
- Sinusitis [13]
- Sinusitis (Pediatrics)
- Preferred Regimen (1): Amoxicillin 90 mg / kg / day PO divided q12h
- Preferred Regimen (2): Amoxicillin-clavulanate (extra strength) suspension, 90 mg / kg / day (based on Amox component), PO divided q12h for 10-14 days
- If non-type I hypersensitivity to penicillin :
- Preferred regimen (1): Cefuroxime axetil 30 mg / kg / day PO divided q12h for 10-14 days
- Alternate Regimen (1): Cefdinir 14 mg / kg / day PO divided q12-24h, max of 600 mg / day for 10-14 days
- Alternate Regimen (2): Cefpodoxime 10 mg / kg / day PO divided q12h for 10-14 days
- Sinusitis (Adults)
- Preferred Regimen (1): Amoxicillin 250-500 mg q8h or 500-875 mg q12h or extended-release tablet 775 mg once daily
- Preferred Regimen (2): Amoxicillin-clavulanate (extended release tabs) 1000 / 62.5 mg 2 tabs or 2000/125 mg 1 tab, PO q12h for 5-7 days
- Alternate Regimen
- If type 1 hypersensitivity to penicillin :
- Preferred regimen (1): Levofloxacin 750 mg PO once daily for 5-7 days
- Preferred regimen (2): Doxycycline 100 mg PO q12h for 5-7 days
- If type 2 hypersensitivity to penicillin :
- Preferred regimen (1): Cefdinir 600 mg / day divided q12h or q24h for 5-7 days
- Preferred regimen (2): Cefpodoxime 200 mg PO q12h for 5-7 days
- Preferred regimen (3): Cefuroxime axetil 500 mg PO q12h for 5-7 days
Sinusitis, Chronic
- Sinusitis [14]
- Sinusitis (Pediatrics)
- Preferred Regimen:Amoxicillin-clavulanate 45 mg/kg per day q12h
- If penicillin allergy and patient is MRSA positive
- Clindamycin 20 to 40 mg/kg per day orally divided every 6 to 8 hours
- If anaerobes are involved
- Metronidazole PLUS one of the following: cefuroxime axetil, cefdinir, cefpodoxime proxetil,azithromycin, clarithromycin, or trimethoprim-sulfamethoxazole (TMP-SMX)
- Sinusitis (Adults)
- Preferred regimen (1): Amoxicillin-clavulanate 500 mg three times daily
- Preferred regimen (2): Amoxicillin-clavulanate 875 mg twice daily
- Preferred regimen (3): Amoxicillin-clavulanate two 1000 mg extended-release tablets twice daily)
- If penicillin allergy and patient is MRSA positive
- Preferred regimen (1): Clindamycin 300 mg four times daily or 450 mg three times daily)
- If anaerobes are involved
- Preferred regimen (1):Metronidazole AND one of the following: cefuroxime axetil, cefdinir, cefpodoxime proxetil, levofloxacin , azithromycin, clarithromycin
- Preferred regimen (2): trimethoprim-sulfamethoxazole (TMP-SMX)
- Alternate regimen: Moxifloxacin (400 mg once daily)
Sinusitis, post-intubation
- Sinusitis [15]
- Preferred regimen (1): Imipenem 0.5 gm IV q6h
- Preferred regimen (2): Meropenem 1 gm IV q8h, MRSA suggestive on Gram - stain then add Vancomycin 1 gm IV q12h
- Alternate Regimen (1): Ceftazidime 2 gm IV q8h AND Vancomycin 1 gm IV q12h)
- Alternate Regimen (2): Cefepime 2 gm IV q12h AND Vancomycin 1 gm IV q12h)
Sinusitis, treatment failure
- Sinusitis (Pediatrics) [16]
- If treatment failure then do a culture and treat accordingly or treatment in the absence of cultures and children failing Amoxicillin
- Amoxicillin-clavulanate (extra strength) suspension 90 mg/kg/day (Amoxicllin component) PO divided q12h for 10-14 days.
- Treatment in the absence of cultures and children failing Amoxicillin-clavulanate
- Clindamycin 30-40 mg/kg/day divided q8h AND third generation cephalosporin like Cefuroxime axetil 30 mg/kg/day PO divided q12h
Preferred regimen (1): Cefdinir 14 mg/kg/day PO divided q12h or q24h Preferred regimen (2):Cefpodoxime 10 mg/kg/day PO divided q12h
- Sinusitis (Adults)
- If failure of treatment even after 7 days of diagnosis
Preferred regimen (1): Amoxicillin-clavulanate 4g per day of amoxicillin equivalent Preferred regimen (2): Levofloxacin 500 mg PO once daily Preferred regimen (3): Moxifloxacin400 mg PO once daily
Stomatitis, aphthous
- Stomatitis [17]
- Topical steroids may decrease pain and swelling
Stomatitis, herpetic
- Stomatitis [18]
- Acyclovir 15 mg/kg PO q5h For 7 days
Submandibular space infection
- Submandibular space infections including Ludwig angina[19]
- Causative pathogens
- Viridans and other streptococci
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host) (1): Penicillin G 2–4 MU IV q4–6h AND Tobramycin 2 mg/kg IV q8h)
- Preferred regimen (immunocompetent host) (2): Ampicillin-Sulbactam 2 g IV q4h
- Preferred regimen (immunocompetent host) (3): Clindamycin 600 mg IV q6h
- Preferred regimen (immunocompetent host) (4): Doxycycline 200 mg IV q12h
- Preferred regimen (immunocompetent host) (5): Cefoxitin 2 g IV q6h
- Preferred regimen (immunocompetent host) (6): Cefotetan 2 g IV q12h
- Preferred regimen (immunocomppromised host) (1): Cefotaxime 2 g IV q6h
- Preferred regimen (immunocomppromised host) (2): Ceftizoxime 4 g IV q8h
- Preferred regimen (immunocomppromised host) (3): Piperacillin 3 g IV q4h
- Preferred regimen (immunocomppromised host) (4): Imipenem 500 mg IV q6h
- Preferred regimen (immunocomppromised host) (5): Meropenem 1 g IV q8h
- Preferred regimen (immunocomppromised host) (6): Gatifloxacin 200 mg IV q24h
Tonsillitis
- Tonsillitis [20]
- Preferred regimen:Penicillin V PO 10 days or if compliance unlikely, Benzathine penicillin IM single dose
- Alternate regimen (1): 2nd generation Cephalosporins PO for 4–6 days
- Alternate regimen (2): Clindamycin or azithromycin for 5 days
- Alternate regimen (3): Clarithromycin for 10 days
- Alternate regimen (4): Erythromycin for 10 days. Extended-release amoxicillin is another (expensive) option
Ulcerative gingivitis
- Provide patient with specific oral hygiene instructions to use a prescription antibacterial mouthwash: Chlorhexidine 0.12% twice daily.[21]
- For any signs of systemic involvement, the recommended antibiotics are:
- Preferred regimen: Amoxicillin, 250 mg 3 x daily for 7 days ± Metronidazole, 250 mg 3 x daily for 7 days
Vincent's angina
- Vincent's angina [22]
- Preferred treatment:Penicillin G 4 million units IV q4h
- Alternate treatment: Clindamycin 600 mg IV q8h
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
- ↑ Reveiz, L.; Cardona, AF.; Ospina, EG. (2005). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev (1): CD004783. doi:10.1002/14651858.CD004783.pub2. PMID 15674965.
- ↑ Reveiz, L.; Cardona, AF.; Ospina, EG. (2007). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev (2): CD004783. doi:10.1002/14651858.CD004783.pub3. PMID 17443555.
- ↑ Reveiz, L.; Cardona, AF. (2013). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev. 3: CD004783. doi:10.1002/14651858.CD004783.pub4. PMID 23543536.
- ↑ Schwartz, SR.; Cohen, SM.; Dailey, SH.; Rosenfeld, RM.; Deutsch, ES.; Gillespie, MB.; Granieri, E.; Hapner, ER.; Kimball, CE. (2009). "Clinical practice guideline: hoarseness (dysphonia)". Otolaryngol Head Neck Surg. 141 (3 Suppl 2): S1–S31. doi:10.1016/j.otohns.2009.06.744. PMID 19729111. Unknown parameter
|month=
ignored (help) - ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
- ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
- ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
- ↑ The first version of this article was adapted from the CDC document "Diphtheria - 1995 Case Definition" athttp://www.cdc.gov/epo/dphsi/casedef/diphtheria_current.htm. As a work of an agency of the U.S. Government without any other copyright notice it should be available as a public domain resource.
- ↑ Thomas, M.; Del Mar, C.; Glasziou, P. (2000). "How effective are treatments other than antibiotics for acute sore throat?". Br J Gen Pract. 50 (459): 817–20. PMID 11127175. Unknown parameter
|month=
ignored (help) - ↑ Spinks, A.; Glasziou, PP.; Del Mar, CB. (2013). "Antibiotics for sore throat". Cochrane Database Syst Rev. 11: CD000023. doi:10.1002/14651858.CD000023.pub4. PMID 24190439.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ "Managing Patients with Necrotizing Ulcerative Gingivitis".
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.