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::* '''Lateral pharyngeal or retropharyngeal space infections (rhinogenic)''' | ::* '''Lateral pharyngeal or retropharyngeal space infections (rhinogenic)''' | ||
:::* Causative pathogens | :::* Causative pathogens | ||
::::* Streptococcus | ::::* Streptococcus pyogenes | ||
::::* | ::::* Fusobacterium | ||
::::* Peptostreptococcus | ::::* Peptostreptococcus | ||
::::* Other oral anaerobes | ::::* Other oral anaerobes | ||
:::* Preferred regimen (immunocompetent host): [[Penicillin G]] 2–4 MU IV q4–6h {{or}} ([[Ciprofloxacin]] 200 mg q12h {{and}} [[Metronidazole]] 0.5 g IV q6h) {{or}} [[Gatifloxacin]] 400 mg IV q24h {{or}} [[Clindamycin]] 600 mg IV q6h | :::* Preferred regimen (immunocompetent host): [[Penicillin G]] 2–4 MU IV q4–6h {{or}} ([[Ciprofloxacin]] 200 mg q12h {{and}} [[Metronidazole]] 0.5 g IV q6h) {{or}} [[Gatifloxacin]] 400 mg IV q24h {{or}} [[Clindamycin]] 600 mg IV q6h | ||
Revision as of 06:37, 11 June 2015
- Deep neck infection
-
- Community-acquired deep neck infection
- Preferred regimen: Ampicillin-Sulbactam 1.5–3.0 g IV q6h OR Clindamycin 600–900 mg IV q8h OR Moxifloxacin 400 mg daily (if Eikenella is suspected)
- Nosocomial deep neck infection or immunocompromised host
- Preferred regimen: Ticarcillin-Clavulanate 3.0 g IV q6h OR Piperacillin-Tazobactam 3.0 g IV q6h OR Imipenem-Cilastatin 500 mg IV q6h OR Ciprofloxacin 400 mg IV q12h OR Levofloxacin 750 mg IV q24h
- Deep neck infection with high-risk of MRSA
- Preferred regimen: (Clindamycin 600–900 mg IV q8h OR Trimethoprim-Sulfamethoxazole 10 mg/kg/day IV q8h) AND Vancomycin 1.0 g IV q12h
- Necrotizing fasciitis
- Preferred regimen: Ceftriaxone 2.0 g IV q8h AND Clindamycin 600–900 mg IV q8h AND Metronidazole 500 mg IV q6h
- Specific anatomic considerations[3]
- Cervical fascial space infections including Ludwig angina
- Causative pathogens
- Viridans and other streptococci
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host): (Penicillin G 2–4 MU IV q4–6h AND Metronidazole 0.5 g IV q6h) OR Ampicillin-Sulbactam 2 g IV q4h OR Clindamycin 600 mg IV q6h OR Doxycycline 200 mg IV q12h OR Cefoxitin 2 g IV q6h OR Cefotetan 2 g IV q12h
- Preferred regimen (immunocomppromised host): Cefotaxime 2 g IV q6h OR Ceftizoxime 4 g IV q8h OR Piperacillin 3 g IV q4h OR Imipenem 500 mg IV q6h OR Meropenem 1 g IV q8h OR Gatifloxacin 200 mg IV q24h
- Lateral pharyngeal or retropharyngeal space infections (odontogenic)
- Causative pathogens
- Viridans and other streptococci
- Staphylococcus
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host): (Penicillin G 2–4 MU IV q4–6h AND Metronidazole 0.5 g IV q6h) OR Ampicillin-Sulbactam 2 g IV q4h OR Clindamycin 600 mg IV q6h
- Preferred regimen (immunocomppromised host): Cefotaxime 2 g IV q6h OR Ceftizoxime 4 g IV q8h OR Piperacillin 3 g IV q4h OR Imipenem 500 mg IV q6h OR Imipenem 500 mg IV q6h OR Gatifloxacin 400 mg IV q24h
- Lateral pharyngeal or retropharyngeal space infections (rhinogenic)
- Causative pathogens
- Streptococcus pyogenes
- Fusobacterium
- Peptostreptococcus
- Other oral anaerobes
- Preferred regimen (immunocompetent host): Penicillin G 2–4 MU IV q4–6h OR (Ciprofloxacin 200 mg q12h AND Metronidazole 0.5 g IV q6h) OR Gatifloxacin 400 mg IV q24h OR Clindamycin 600 mg IV q6h
- Preferred regimen (immunocomppromised host): Cefotaxime 2 g IV q6h OR Ceftizoxime 4 g IV q8h OR Piperacillin 3 g IV q4h OR Imipenem 500 mg IV q6h OR Imipenem 500 mg IV q6h OR Gatifloxacin 400 mg IV q24h
- Lateral pharyngeal or retropharyngeal space infections (orogenic)
- Causative pathogens
- Streptococcus pneumoniae
- Haemophilus influenzae
- Viridans and other streptococci
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host): Penicillin G 2–4 MU IV q4–6h OR (Ciprofloxacin 200 mg q12h AND Metronidazole 0.5 g IV q6h) OR Gatifloxacin 400 mg IV q24h OR Clindamycin 600 mg IV q6h
- Preferred regimen (immunocomppromised host): Cefotaxime 2 g IV q6h OR Ceftizoxime 4 g IV q8h OR Piperacillin 3 g IV q4h OR Imipenem 500 mg IV q6h OR Imipenem 500 mg IV q6h OR Gatifloxacin 400 mg IV q24h
- Peritonsillar abscess (quinsy)
- Causative pathogens
- Viridans and other streptococci
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host): (Penicillin G 2–4 MU IV q4–6h AND Metronidazole 0.5 g IV q6h) OR Ampicillin-Sulbactam 2 g IV q4h OR Clindamycin 600 mg IV q6h OR Doxycycline 200 mg IV q12h OR Cefoxitin 2 g IV q6h OR Cefotetan 2 g IV q12h
- Preferred regimen (immunocomppromised host): Cefotaxime 2 g IV q6h OR Ceftizoxime 4 g IV q8h OR Piperacillin 3 g IV q4h OR Imipenem 500 mg IV q6h OR Meropenem 1 g IV q8h OR Gatifloxacin 200 mg IV q24h
.
- ↑ Flint, Paul (2010). Cummings otolaryngology head & neck surgery. Philadelphia, PA: Mosby/Elsevier. ISBN 978-0323052832.
- ↑ Vieira, Francisco; Allen, Shawn M.; Stocks, Rose Mary S.; Thompson, Jerome W. (2008-06). "Deep neck infection". Otolaryngologic Clinics of North America. 41 (3): 459–483, vii. doi:10.1016/j.otc.2008.01.002. ISSN 0030-6665. PMID 18435993. Check date values in:
|date=(help) - ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.