Epiglottitis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Medical Therapy

Patients should receive empiric antibiotic treatment after sample for throat culture has been taken. The recomended treatment is a combination of a third generation cephaplosporin such as ceftriaxone or cefotaxime with an antistaphylococcal agent, active against.Template:Cita publicación

Empiric Therapy Adapted from Lancet. 2012;380(9854):1693-702. and Clin Infect Dis. 2004;39(9):1267-84.

Pediatric patient Preferred Regimen ▸ Vancomycin 10 mg/kg per dose IV q4h PLUS ▸ Ceftriaxone 50-75 mg/kg administered IV q24h OR Cefotaxime 50 mg/kg IV q8h Alternative Regimen (If Allergic to Penicillin) ▸ Clindamycin 7.5 mg/kg mg IV q6h PLUS ▸ Levofloxacin 100 mg/kg IV q24h Adult patient Preferred Regimen ▸ Vancomycin 1 g IV q12h PLUS ▸ Ceftriaxone 2 g IV q24h OR Cefotaxime 2 g IV q8h Alternative Regimen (If Allergic to Penicillin) ▸ Clindamycin 600-900 mg IV q6h PLUS ▸ Levofloxacin 750 mg IV q24h Pathogen based theerapy ▸ Click on the following categories to expand treatment regimens. Bacteria   ▸  Streptococcus pneumoniae   ▸  Streptococcus sp   ▸  Staphylococcus aureus   ▸  Haemophilus influenzae type B   ▸  Klebsiella pneumoniae   ▸  Moraxella catarrhalis   ▸  Neisseria sp   ▸  Pasteurella multocida   ▸  Pseudomonas sp Haemophilus influenzae Preferred Regimen ▸ Meropenem 2 g IV q8h Alternative Regimen ▸ Colistin 1.25 mg/kg IV q6—12h OR ▸ Polymyxin B 0.75—1.25 mg/kg IV q12h Streptococcus pneumoniae Preferred Regimen (sussceptible to penicillin) ▸ Penicillin G 2 million units IV q4h OR ▸ Ceftriaxone 2 g IV q24h OR Clindamycin 600 mg IV q6h Alternative Regimen (penicillin resistant strains) ▸ Moxifloxacin 400 mg IV q24h OR ▸ Levofloxacin 750 mgIV q24h OR ▸ Vancomycin 1 g IV q12h OR ▸ Linezolid 600 mg IV q12h OR ▸ Ceftaroline 600 mg IV q12h Streptococcus pyogenes Streptococcus viridans Meticillin susceptible Staphylococcus aureus Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) Meticilling resistant Staphylococcus aureus Preferred Regimen ▸ Vancomycin 15-20 mg/kg IV q8-12h OR ▸ Daptomycin 4-6 mg/kg IV q24h OR ▸ Linezolid 600 mg IV q12h Alternative Regimen (Vancomycin intermmediate sussceptibility) ▸ Linezolid 600 mg/kg IV q12h OR ▸ Daptomycin 4-6 mg/kg IV q24h OR ▸ Ceftraoline 600 mg IV q8h Alternative Regimen (Vancomycin resistance) ▸ Teicoplanin 6 mg/kg IV q12h (total of three doses), 6 mg/kg IV q24h OR ▸ Telavancin 10 mg/kg q24h (1 hour infusion) OR ▸ Linezolid 600 mg/kg IV q12h OR ▸ Daptomycin 4-6 mg/kg IV q24h Klebsiella pneumoniae Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) Moraxella catrrhalis Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) Neisseria sp Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) Pasteurella maltocida Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) Pseudomona sp Preferred Regimen ▸ Ampicillin 2 g IV q4h OR ▸ Penicillin G 4 MU IV q4h PLUS ▸ Gentamicin 1.7 mg/kg IV q8h Alternative Regimen ▸ TMP/SMZ 5 mg/kg IV q6—12h (TMP component) Other treatments may include: Anti-inflammatory medicines called corticosteroids to decrease throat swelling Fluids given through a vein (by IV) References