Hospitalized Adults: Head and Neck Infections: Peritonsillar Abscess

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Doses provided in this table are for patients with normal renal and hepatic function. Click on drug link to go to dosing guidelines.  Some antimicrobials are restricted (ID-R).  Click on link for guidelines on obtaining authorization.

Diagnosis

Common Pathogens

Drug(s) of First Choice

Alternative Drug(s)

Comments

Peritonsillar abscess, deep neck infections

 

Group A streptococci

Anaerobes

S. aureus

Ampicillin/sulbactam 3 g IV q6h

WITH OR WITHOUT*

Vancomycin

 

Alternatively:

Ertapenem 1 g IV daily

WITH OR WITHOUT*

Vancomycin

 

Alternatively:

Metronidazole 500 mg IV/PO q8h

PLUS

Ceftriaxone1 g IV q24h

WITH OR WITHOUT*

Vancomycin

For severe PCN allergy:

ClindamycinID-R: VASF 600 – 900 mg IV q8h

PLUS

CiprofloxacinID-R: VASF 400 mg IV q12h

OR

LevofloxacinID-R: VASF 500 mg IV daily

 

Often polymicrobial 

 

Combinations of piperacillin/tazobactam, ampicillin/sulbactam, or ertapenem PLUS metronidazole should not be used. 

 

*Consider vancomycin use for patients at high risk for MRSA