Sandbox ID Upper Respiratory Tract: Difference between revisions

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*Alternate regimen (3): [[Azithromycin]]PO 12 mg/kg once daily (max = 500 mg) for 5 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
*Alternate regimen (4): [[Clarithromycin]] PO 7.5 mg/kg/dose twice daily (max = 250 mg/dose) for 10 days
::*Chronic
:*Chronic
::*Preferred regimen (1): [[Clindamycin]] 20–30 mg/kg/d in 3 doses (max = 300 mg/dose) for 10 days
::*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 (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

Revision as of 18:25, 29 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:

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)
  • 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
  • Alternate regimen

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.
  • Sinusitis (Adults)

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

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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