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Guidelines
Pathogens
Antimicrobials
If abscess documented, consult ENT.
If older child or adolescent with neck pain and significant illness, consider jugular venous septic phlebitis (Lemiere's syndrome) caused by Fusobacterium and perform appropriate imaging.
Droplet / Contact Precautions
Until 24 hours of appropriate antimicrobial therapy
Streptococcus pyogenes (GAS)
S. aureus
Fusobacterium sp.
Anaerobic streptococci species
Ampicillin IV
OR
CeFAZolin IV
*If abscess seen on imaging or *in severely ill patient ADD
MetroNIDAZOLE*
Spectrum may be narrowed to a more specific agent if cultures indicate a specific pathogen.
10 days including oral conversion to Amoxicillin - Clavulanic acid OR CeFURoxime axetil when afebrile for 24 - 48 hours and clinically improved
