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{{PBI|Histoplasmosis}}
===Epiglottitis===
:* 1. '''Adult treatment:'''  <ref name="pmid16206093">{{cite journal| author=Galgiani JN, Ampel NM, Blair JE, Catanzaro A, Johnson RH, Stevens DA et al.| title=Coccidioidomycosis. | journal=Clin Infect Dis | year= 2005 | volume= 41 | issue= 9 | pages= 1217-23 | pmid=16206093 | doi=10.1086/496991 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16206093  }} </ref>
*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>
::* 1.1 '''Pulmonary'''
:*Pediatrics
:::* 1.1.1 '''Acute pulmonary histoplasmosis'''
::*Preferred regimen (1): [[Cefotaxime]] 50 mg/kg IV q8h
::::* 1.1.1.1 '''Moderate severe or severe'''
::*Preferred regimen (2): [[Ceftriaxone]] 50–75 mg/kg/day IV q12–24h {{and}} [[Vancomycin]] 10 mg/kg IV q6h
:::::* Preferred regimen (1): Lipid formulation of [[Amphotericin B]] (3.0–5.0 mg/kg IV q12h for 1–2 weeks) {{then}} [[Itraconazole]] (200 mg tid for 3 days {{then}} 200 mg bid for a total of 12 weeks).
::*Alternate regimen (1): [[Levofloxacin]] 500 mg IV q24h (or 8 mg/kg IV q12h) {{and}} [[Clindamycin]] 20–40 mg/kg/day IV q6–8h
:::::* Alternative regimen (2): The deoxycholate formulation of [[Amphotericin B]] (0.7–1.0 mg/kg q24h IV) is an alternative to a lipid formulation in patients who are at a low risk for nephrotoxicity (A-III)
:::::* Preferred regimen (3): Methylprednisolone (0.5–1.0 mg/kg daily intravenously) during the first 1–2 weeks of antifungal therapy is recommended for patients who develop respiratory complications, including hypoxemia or significant respiratory distress (B-III).
:::::* Note (1): In severe cases, cases accompanied by respiratory insufficiency, or hypoxemia, anecdotal reports [49] suggest that corticosteroid therapy may hasten recovery
:::::* Note (2): The pulmonary infiltrates should be resolved on the chest radiograph before antifungal therapy is stopped.
::* 1.1.1.2 '''Mild to moderate:'''
:::::* Treatment is usually unnecessary
:::::* Patients who continue to have symptoms for >1 month: Itraconazole (200 mg 3 times daily for 3 days and then 200 mg once or twice daily for 6–12 weeks)
:::::* Note (1): Antifungal treatment is unnecessary in patients with mild symptoms caused by acute pulmonary histoplasmosis


:*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


::* 1.1.2 '''Chronic cavitary pulmonary histoplasmosis:'''
===Jugular vein phlebitis===
::::* Preferred regimen: Itraconazole (200 mg 3 times daily for 3 days and then once or twice daily for at least 1 year) is recommended
* '''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>
::::* Note (1): Blood levels of itraconazole should be obtained after the patient has been receiving this agent for at least 2 weeks to ensure adequate drug exposure
:* Causative pathogens
::::* Note (2): Patients with underlying emphysema often develop progressive pulmonary disease, which is characterized by cavities with surrounding inflammation, after infection with Hysotplasma capsulatum
::* 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>


::* 1.1.3 '''Broncholithiasis'''
===Lemierre's syndrome===
:::* Antifungal treatment is not recommended **
* '''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>
:::* Note: Bronchoscopic or surgical removal of the broncholith is recommended
:* 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


::* 1.1.4 '''Pulmonary Nodules (Histoplasmomas)'''
===Parapharyngeal space infection===
:::* Antifungal treatment is not recommended**
* '''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>
:::* Note: Lung parenchymal sites of infection may contract and then persist indefinitely as lung nodules or histoplasmomas.... (what about this large comment)
:* 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


::* 1.2 '''Mediastinitis'''  (alphabetic order)
===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


:::* 1.2.1 '''Mediastinal Lymphadenitis'''
===Sinusitis, Acute===
:::* Treatment is usually unnecessary (if asympthomatic)**
*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>
:::* 1.2.2 '''Patients who have symptoms that warrant treatment with corticosteroids and in those who continue to have symptoms for >1 month'''
::::* Itraconazole (200 mg 3 times daily for 3 days and then 200 mg once or twice daily for 6–12 weeks)
:::* 1.2.3 '''Severe cases with obstruction or compression of contiguous structures'''
::::* Preferred regimen: Prednisone (0.5–1.0 mg/kg daily [maximum, 80 mg daily] in tapering doses over 1–2 weeks)
::::* Note:  Antifungal treatment is unnecessary in most patients with symptoms due to mediastinal lymphadenitis
::::* Note (2): Itraconazole is recommended for 6–12 weeks to reduce the risk of progressive disseminated disease caused by corticosteroid-induced immunosuppression in patients who are given corticosteroids and in patients whose symptoms last longer than 1 month.


*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


:::* 1.2.2 '''Mediastinal Granuloma'''
:*Alternate Regimen 
:::* Treatment is usually unnecessary **
:::* 1.2.2.1 '''Symptomatic cases'''
:::* Preferred regimen: Itraconazole (200 mg 3 times daily for 3 days and then once or twice daily for 6–12 weeks)
::::* Note: Itraconazole is appropriate for symptomatic cases, but there are no controlled trials to prove its efficacy.
::::* Note (2): There is no evidence that mediastinal granuloma evolves into mediastinal fibrosis. Thus, treatment with either surgery or itraconazole should not be used to prevent the development of mediastinal fibrosis


::*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


:::* 1.2.3 '''Mediastinal Fibrosis'''
::*If type 2 hypersensitivity to penicillin :
:::* Antifungal treatment is not recommended**
:*Preferred regimen (1): [[Cefdinir]] 600 mg / day divided q12h or q24h for 5-7 days
:::* 1.2.3.1 '''If clinical findings cannot differentiate mediastinal fibrosis from mediastinal granuloma''' No differentiate from mediastinal fibrosis and granuloma ***
:*Preferred regimen (2): [[Cefpodoxime]] 200 mg PO q12h for 5-7 days
:::* Preferred regimen: Itraconazole (200 mg once or twice daily for 12 weeks)
:*Preferred regimen (3): [[Cefuroxime axetil]] 500 mg PO q12h for 5-7 days
::::* Note: The placement of intravascular stents is recommended for selected patients with pulmonary vessel obstruction
::::* Note (2): Mediastinal fibrosis is characterized by invasive fibrosis that encases mediastinal or hilar nodes and that is defined by occlusion of central vessels and airways


===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>


::* 3. '''Pericarditis:'''
*Sinusitis (Pediatrics)
:::* 3.2 '''Mild cases'''
:*Preferred Regimen:[[Amoxicillin-clavulanate]] 45 mg/kg per day q12h
::::* Preferred regimen: Nonsteroidal anti-inflammatory therapy
:*If penicillin allergy and patient is MRSA positive
:::* 3.3 '''Patients with evidence of hemodynamic compromise or unremitting symptoms after several days of therapy with nonsteroidal anti-inflammatory therapy:'''
::*[[Clindamycin]] 20 to 40 mg/kg per day orally divided every 6 to 8 hours
::::* Prednisone (0.5–1.0 mg/kg daily [maximum, 80 mg daily] in tapering doses over 1–2 weeks)
:*If anaerobes are involved
:::* 3.4 '''If corticosteroids are administered '''
::*[[Metronidazole]] PLUS one of the following: [[cefuroxime axetil]], [[cefdinir]], [[cefpodoxime proxetil]],[[azithromycin]], [[clarithromycin]], or [[trimethoprim-sulfamethoxazole]] (TMP-SMX)
::::* Preferred regimen: Itraconazole (200 mg 3 times daily for 3 days and then once or twice daily for 6–12 weeks)
::::* Note: Pericardial fluid removal is indicated for patients with hemodynamic compromise
::::* Note: Pericarditis occurs as a complication of inflammation in adjacent mediastinal lymph nodes in patients with acute pulmonary histoplasmosis.


*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)


::* 4. '''Rheumatologic Syndromes'''
===Sinusitis, post-intubation===
:::* 4.1 '''Mild cases:'''
*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: Nonsteroidal anti-inflammatory therapy
:*Preferred regimen (1): [[Imipenem]] 0.5 gm IV q6h
:::* 4.2 '''Severe cases:'''
:*Preferred regimen (2): [[Meropenem]] 1 gm IV q8h, MRSA suggestive on Gram - stain then add [[Vancomycin]] 1 gm IV q12h
::::* Preferred regimen: Prednisone (0.5–1.0 mg/kg daily [maximum, 80 mg daily] in tapering doses over 1–2 weeks)
:*Alternate Regimen (1): [[Ceftazidime]] 2 gm IV q8h {{and}} [[Vancomycin]] 1 gm IV q12h)
:::* 4.3'''Corticosteroids administration:'''
:*Alternate Regimen (2): [[Cefepime]] 2 gm IV q12h {{and}} [[Vancomycin]] 1 gm IV q12h)
::::* Itraconazole (200 mg 3 times daily for 3 days and then once or twice daily for 6–12 weeks)
::::* Note: If corticosteroids are used, concurrent itraconazole treatment is recommended to reduce the risk of progressive infection
::::* Note (2): Bone or joint involvement is very rare in progressive disseminated histoplasmosis, but it should not be overlooked.


===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


::* 5. '''Mediastinal Lymphadenitis'''
*Sinusitis (Adults)
:::* 5.1 Treatment is usually unnecessary (if asympthomatic)**
:*If failure of treatment even after 7 days of diagnosis
:::* 5.2 '''Patients who have symptoms that warrant treatment with corticosteroids and in those who continue to have symptoms for >1 month'''
Preferred regimen (1): [[Amoxicillin-clavulanate]] 4g per day of amoxicillin equivalent
::::* Itraconazole (200 mg 3 times daily for 3 days and then 200 mg once or twice daily for 6–12 weeks)
Preferred regimen (2): [[Levofloxacin]] 500 mg PO once daily
:::* 5.3 '''Severe cases with obstruction or compression of contiguous structures'''
Preferred regimen (3): [[Moxifloxacin]]400 mg PO once daily
::::* Preferred regimen: Prednisone (0.5–1.0 mg/kg daily [maximum, 80 mg daily] in tapering doses over 1–2 weeks)
::::* Note:  Antifungal treatment is unnecessary in most patients with symptoms due to mediastinal lymphadenitis
::::* Note (2): Itraconazole is recommended for 6–12 weeks to reduce the risk of progressive disseminated disease caused by corticosteroid-induced immunosuppression in patients who are given corticosteroids and in patients whose symptoms last longer than 1 month.


===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


::* 6. '''Mediastinal Granuloma'''
===Stomatitis, herpetic===
:::* 6.1 Treatment is usually unnecessary **
*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>
:::* 6.2 '''Symptomatic cases'''
:*[[Acyclovir]] 15 mg/kg PO q5h For 7 days
:::* Preferred regimen: Itraconazole (200 mg 3 times daily for 3 days and then once or twice daily for 6–12 weeks)
::::* Note: Itraconazole is appropriate for symptomatic cases, but there are no controlled trials to prove its efficacy.
::::* Note (2): There is no evidence that mediastinal granuloma evolves into mediastinal fibrosis. Thus, treatment with either surgery or itraconazole should not be used to prevent the development of mediastinal fibrosis


===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


::* 7. '''Mediastinal Fibrosis'''
:* Preferred regimen (immunocompetent host) (6): [[Cefotetan]] 2 g IV q12h
:::* 7.1 Antifungal treatment is not recommended**
:* Preferred regimen (immunocomppromised host) (1): [[Cefotaxime]] 2 g IV q6h
:::* 7.2 '''If clinical findings cannot differentiate mediastinal fibrosis from mediastinal granuloma''' No differentiate from mediastinal fibrosis and granuloma ***
:* Preferred regimen (immunocomppromised host) (2): [[Ceftizoxime]] 4 g IV q8h
:::* Preferred regimen: Itraconazole (200 mg once or twice daily for 12 weeks)
:* Preferred regimen (immunocomppromised host) (3): [[Piperacillin]] 3 g IV q4h
::::* Note: The placement of intravascular stents is recommended for selected patients with pulmonary vessel obstruction
:* Preferred regimen (immunocomppromised host) (4): [[Imipenem]] 500 mg IV q6h
::::* Note (2): Mediastinal fibrosis is characterized by invasive fibrosis that encases mediastinal or hilar nodes and that is defined by occlusion of central vessels and airways
:* 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


::* 8. '''Broncholithiasis'''
:*Alternate regimen (1): [[Cephalosporins|2nd generation Cephalosporins]] PO for 4–6 days
:::* 8.1 Antifungal treatment is not recommended **
:*Alternate regimen (2): [[Clindamycin]] or [[azithromycin]] for 5 days
:::* Note: Bronchoscopic or surgical removal of the broncholith is recommended
:*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>


::* 9. '''Pulmonary Nodules (Histoplasmomas)'''
*For any signs of systemic involvement, the recommended antibiotics are:
:::* Antifungal treatment is not recommended**
:*Preferred regimen: [[Amoxicillin]], 250 mg 3 x daily for 7 days {{withorwithout}} [[Metronidazole]], 250 mg 3 x daily for 7 days
:::* Note: Lung parenchymal sites of infection may contract and then persist indefinitely as lung nodules or histoplasmomas.... (what about this large comment)


===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


::* 10. '''Progressive Disseminated Histoplasmosis'''
:::* 10.1 '''Moderately severe to severe disease'''
::::* Preferred regimen: Liposomal amphotericin B (3.0 mg/kg daily) is recommended for 1–2 weeks, followed by oral itraconazole (200 mg 3 times daily for 3 days and then 200 mg twice daily for a total of at least 12 months)
::::* Note: Substitution of another lipid formulation at a dosage of 5.0 mg/kg daily may be preferred in some patients because of cost or tolerability
::::* Note (2): The deoxycholate formulation of amphotericin B (0.7–1.0 mg/kg daily) is an alternative to a lipid formulation in patients who are at a low risk for nephrotoxicity
::::* 10.2 '''Immunosupressed patients'''
::::* Lifelong suppressive therapy with itraconazole (200 mg daily)
::::* 10.3 '''Mild to moderate disease'''
::::* Itraconazole (200 mg 3 times daily for 3 days and then twice daily for at least 12 months)
::::* Note: Lifelong suppressive therapy with itraconazole (200 mg daily) may be required in immunosuppressed patients if immunosuppression cannot be reversed and in patients who relapse despite receipt of appropriate therapy
::::*  Note (2): Blood levels of itraconazole should be obtained to ensure adequate drug exposure
::::* Note (3): Antigen levels should be measured during therapy and for 12 months after therapy is ended to monitor for relapse (B-III). Persistent low-level antigenuria may not be a reason to prolong treatment in patients who have completed appropriate therapy and have no evidence of active infection.
***evidence summary...
::* 10.'''Prophylaxis Recommended for Immunosuppressed Patients'''
::::* Preferred regimen: Itraconazole (200 mg daily) in patients with HIV infection with CD4 cell counts <150 cells/mm3 in specific areas of endemicity where the incidence of histoplasmosis is >10 cases per 100 patient-years
::::* Note: Prophylaxis with itraconazole (200 mg daily) may be appropriate in specific circumstances in other immunosuppressed patients
***evidence summary...
::* 11.'''Treatment for Central nervous system Histoplasmosis'''
::::* Preferred regimen: Liposomal amphotericin B (5.0 mg/kg daily for a total of 175 mg/kg given over 4–6 weeks) followed by itraconazole (200 mg 2 or 3 times daily) for at least 1 year and until resolution of CSF abnormalities, including Histoplasma antigen levels.
::::* Note: Blood levels of itraconazole should be obtained to ensure adequate drug exposure
***evidence summary...
::* 12.'''Histoplasmosis in Pregnancy'''
::::* Preferred regimen: Lipid formulation amphotericin B (3.0–5.0 mg/kg daily for 4–6 weeks) is recommended
::::* Prefered regimen low risk for nephrotoxicity: The deoxycholate formulation of amphotericin B (0.7–1.0 mg/kg daily) is an alternative to a lipid formulation
::::* Note: If the newborn shows evidence for infection, treatment is recommended with amphotericin B deoxycholate (1.0 mg/kg daily for 4 weeks)
::::* Note (2):  Unique issues in pregnancy include the risk of teratogenic complications of azole therapy [93] and of transplacental transmission of H. capsulatum to the fetus
::* 13.'''Histoplasmosis in Children'''
::::* 13.1 '''Acute pulmonary histoplasmosis'''
::::* Note: Treatment indications and regimens are similar to those for adults, except that amphotericin B deoxycholate (1.0 mg/kg daily) is usually well tolerated, and the lipid preparations are not preferred
::::* Itraconazole dosage: 5.0–10.0 mg/kg daily in 2 divided doses (not to exceed 400 mg daily), generally using the solution formulation
::::* 13.2 '''Progressive Disseminated Histoplasmosis'''
::::* Preferred regimen: Amphotericin B deoxycholate (1.0 mg/kg daily for 4–6 weeks)
::::* Alternative regimen: Amphotericin B deoxycholate (1.0 mg/kg daily for 2–4 weeks) followed by itraconazole (5.0–10.0 mg/kg daily in 2 divided doses) to complete 3 months of therapy
::::* Note: Longer therapy may be needed for patients with severe disease, immunosuppression, or primary immunodeficiency syndromes
::::*  Immunosuppressed patients and in patients who experience relapse despite receipt of appropriate therapy: Lifelong suppressive therapy with itraconazole (5.0 mg/kg daily, up to 200 mg daily)
::::* Note: Blood levels of itraconazole should be obtained to ensure adequate drug exposure
::::* Note (2):  Antigen levels should be monitored during therapy and for 12 months after therapy is ended to monitor for relapse. Persistent low-level antigenuria may not be a reason to prolong treatment in patients who have completed appropriate therapy and have no evidence of active infection.
::::* Note (3):  Progressive disseminated histoplasmosis in children is fatal if untreated. Amphotericin B deoxycholate (1 mg/kg daily) given for 4 weeks has been used successfully and with minimal toxicity.
::::* Note (4): A lipid formulation of amphotericin B (3–5 mg/kg daily) may be substituted if the patient is intolerant of amphotericin B deoxycholate. A shorter course of amphotericin B followed by an azole was effective in 74% of cases [101] and is an alternative to a prolonged course of amphotericin B treatment.
***Evidence summary
::::* 14'''Performance Measures''' ***
::::* Preferred regimen: Itraconazole is the preferred azole for initial therapy for patients with mild-to-moderate histoplasmosis and as step-down therapy after receipt of amphotericin B
::::* Note: When other azole agents are used, the medical record should document the specific reasons that itraconazole was not used and why other azoles were used.
::::* 14.1 '''Severe or moderately severe histoplasmosis'''
::::* Preferred regimen: Amphotericin B.
::::* Note: When amphotericin B is used, the patient's electrolyte level, renal function, and blood cell count should be monitored several                    times per week and documented in the medical record.
::::* Note (2): Itraconazole drug levels should be measured during the first month in patients with disseminated or chronic pulmonary histoplasmosis, and these levels should be documented in the medical record, as well as the physician's response to levels that are too low.
::::* Note (3): Itraconazole should not be given to patients receiving contraindicated medications (i.e., pimozide, quinidine, dofetilide, lovastatin, simvastatin, midazolam, and triazolam). Reasons for deviation from this practice should be documented in the medical record.
==References==
{{reflist}}
{{reflist}}

Latest revision as of 18:00, 30 July 2015

Epiglottitis

  • Epiglottitis [1]
  • Pediatrics
  • Adults

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

  • 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

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 (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 (Pediatrics)
  • Clindamycin 20 to 40 mg/kg per day orally divided every 6 to 8 hours
  • If anaerobes are involved
  • Sinusitis (Adults)

Sinusitis, post-intubation

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.

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, herpetic

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

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:

Vincent's angina

  • Vincent's angina [22]
  1. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  2. ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ 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)
  7. ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  8. ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  9. ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  10. ↑ 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.
  11. ↑ 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)
  12. ↑ 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.
  13. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  14. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  15. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  16. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  17. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  18. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  19. ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.
  20. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  21. ↑ "Managing Patients with Necrotizing Ulcerative Gingivitis".
  22. ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
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