Sandbox ID Upper Respiratory Tract
Epiglottitis
- Epiglottitis
- Pediatrics
- Preferred regimen : Cefotaxime 50 mg/kg IV q8h OR Ceftriaxone 50–75 mg/kg/day IV q12–24h AND Vancomycin 10 mg/kg IV q6h
- Alternate regimen : Levofloxacin 500 mg IV q24h (or 8 mg/kg IV q12h) AND Clindamycin 20–40 mg/kg/day IV q6–8h
- Adults
- Preferred regimen : Cefotaxime 2 g IV q4–8h OR Ceftriaxone 1–2 g/day IV q12–24h AND Vancomycin 2 g/day IV q6–12h
- Alternate regimen : Levofloxacin 750 mg IV q24h AND Clindamycin 600–1200 mg IV q6–12h
Jugular vein phlebitis
- Septic jugular thrombophlebitis (Lemierre's syndrome)[1]
- Causative pathogens
- Fusobacterium
- 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
Laryngitis
Lemierre's syndrome
- Septic jugular thrombophlebitis (Lemierre's syndrome)[2]
- Causative pathogens
- Fusobacterium
- 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
Ludwig's angina
- Ludwig's angina[3]
- Causative pathogens
- Viridans and other streptococci
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host): (Penicillin G 2–4 MU IV q4–6h AND Tobramycin 2 mg/kg IV q8h) 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
Parapharyngeal space infection
- Parapharyngeal space infection[4]
- 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
Pharyngitis, diphtheria
- Diphtheria[5]
- The CDC recommends either:
- Preferred regimen: Erythromycin (PO or by IV) for 14 days (40 mg/kg per day with a maximum of 2 g/d), OR 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 to penicillin G or erythromycin can use rifampin or clindamycin.
Pharyngitis, streptococcal
- Acute
- Preferred regimen
- Children: Pencillin V PO 250 mg twice daily or 3 times daily
- Adolescents and adults: Pencillin V PO 250 mg 4 times daily or 500 mg twice daily for 10 days OR Amoxicillin 50 mg/kg once daily (max = 1000 mg) alternate:25 mg/kg (max = 500 mg) twice daily for 10 days OR Benzathine Penicillin G I.M 27 kg: 600 000 U; ≥27 kg: 1 200 000 U 1 dose only OR Cephalexin PO 20 mg/kg/dose twice daily (max = 500 mg/dose)for 10 days
- Alternate regimen :
- Cefadroxil PO 30 mg/kg OD (max = 1 g) for 10 days OR Clindamycin PO 7 mg/kg/dose 3 times daily (max = 300 mg/dose) for 10 days OR AzithromycinPO 12 mg/kg once daily (max = 500 mg) for 5 days OR Clarithromycin PO 7.5 mg/kg/dose twice daily (max = 250 mg/dose) for 10 days
- Chronic
- Preferred regimen
- Clindamycin 20–30 mg/kg/d in 3 doses (max = 300 mg/dose) for 10 days OR 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 OR 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 : Amoxicillin 90 mg / kg / day PO divided q12h OR Amoxicillin-clavulanate (extra strength) suspension, 90 mg / kg / day (based on Amox component), PO divided q12h for 10-14 days
- Alternate Regimen
- If non-type I hypersensitivity to penicillin : Cefuroxime axetil 30 mg / kg / day PO divided q12h for 10-14 days OR Cefdinir 14 mg / kg / day PO divided q12-24h, max of 600 mg / day for 10-14 days OR Cefpodoxime 10 mg / kg / day PO divided q12h for 10-14 days
- Sinusitis (Adults)
- Preferred Regimen : Amoxicillin 250-500 mg q8h or 500-875 mg q12h or extended-release tablet 775 mg once daily OR 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 : Levofloxacin 750 mg PO once daily for 5-7 days OR Doxycycline 100 mg PO q12h for 5-7 days
- If type 2 hypersensitivity to penicillin : Cefdinir 600 mg / day divided q12h or q24h for 5-7 days OR Cefpodoxime 200 mg PO q12h for 5-7 days OR Cefuroxime axetil 500 mg PO q12h for 5-7 days
Sinusitis, Chronic
- 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)
ADULTS Preferred Regimen Amoxicillin-clavulanate 500 mg three times daily OR 875 mg twice daily OR two 1000 mg extended-release tablets twice daily) If penicillin allergy and patient is MRSA positive Clindamycin 300 mg four times daily or 450 mg three times daily) If anaerobes are involved Metronidazole PLUS one of the following: cefuroxime axetil, cefdinir, cefpodoxime proxetil, levofloxacin , azithromycin, clarithromycin, or trimethoprim-sulfamethoxazole (TMP-SMX) Alternate regimen Moxifloxacin (400 mg once daily)
Sinusitis, Post-intubation
- Sinusitis
- Preferred regimen : Imipenem 0.5 gm IV q6h OR Meropenem 1 gm IV q8h, MRSA suggestive on Gram - stain then add Vancomycin 1 gm IV q12h
- Alternate Regimen : (Ceftazidime 2 gm IV q8h AND Vancomycin 1 gm IV q12h) OR (Cefepime 2 gm IV q12h AND Vancomycin 1 gm IV q12h)
Sinusitis, Treatment failure
- Sinusitis (Pediatrics)
- 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 OR Cefdinir 14 mg/kg/day PO divided q12h or q24h OR Cefpodoxime 10 mg/kg/day PO divided q12h
- Sinusitis (Adults)
- If failure of treatment even after 7 days of diagnosis : Amoxicillin-clavulanate 4g per day of amoxicillin equivalent OR Levofloxacin 500 mg PO once daily ORMoxifloxacin400 mg PO once daily
Stomatitis
Stomatitis, aphthous
Stomatitis, herpetic
Submandibular space infection
- Submandibular space infections including Ludwig angina[8]
- Causative pathogens
- Viridans and other streptococci
- Peptostreptococcus
- Bacteroides
- Other oral anaerobes
- Preferred regimen (immunocompetent host): (Penicillin G 2–4 MU IV q4–6h AND Tobramycin 2 mg/kg IV q8h) 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
Tonsillitis
Ulcerative gingivitis
Vincent's angina
- ↑ 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.
- ↑ 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.
- ↑ Hall, Jesse (2015). Principles of critical care. New York: McGraw-Hill Education. ISBN 978-0071738811.