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Syndrome
Primary Rx

Alternate Rx

Comments
Pharyngitis, streptococcal
  • Penicillin V 500 mg qid x 10d
  • Erythromycin
  • Clindamycin
  • Cephalexin
 Diagnosis is based on streptococcal throat screen or culture.
Sinusitis, acute
  • Amoxicillin 500-1000 mg tid
  • Azithromycin 500 mg x 1; 250 mg daily thereafter
  • Doxycycline 100 mg bid
  • Amoxicillin/clavulanate
  • 2nd gen cephalosporin
  • Resp quinolone
  • TMP/SMX
 Symptoms should have been present for more than 7 days. Antibiotic therapy is not always indicated.
Sinusitis, chronic
  • Value of antibiotics is uncertain; consider ENT and/or ID consultation.
Bronchitis, acute
  • Antibiotics are not indicated.
 This is usually viral in orgin.
Otitis media, acute
  • Amoxicillin--
  • Peds 15-30 mg/kg tid
  • Adults 500-1000 mg tid
  • 2nd generation cephalosporin
  • Amoxicillin/clavulanate
  • Azithromycin
  • Ceftriaxone
 Antibiotics are not always required.
COPD, acute exacerbation
  • Doxycycline 100 mg po bid
  • Amoxicillin 500-1000 mg po tid
  • TMP/SMX
  • 2nd gen cephalosporin
  • Azithromycin
  • Respiratory quinolone
 Antibiotics are not always indicated.
Pneumonia, community acquired - outpatient
  • Azithromycin 500 mg po daily
  • Doxycycline 100 mg po bid
  • (2nd gen cephalosporin or Amoxicillin) + Azithromycin
 Use respiratory quinolone if significant comorbidities present.
Pneumonia, community acquired - inpatient, non-ICU
  • Ceftriaxone 1-2 gm IV qd + Azithromycin 500 mg qd
  • Resp quinolone
Pneumonia, community acquired - inpatient, ICU, non-pseudomonal
  • (Ceftriaxone 2 gm IV qd or Amp/sulbactam 3 gm IV q6) + (Azithromycin 500 mg qd or Resp quinolone)
  • Resp quinolone + Aztreonam
 Add Vancomycin (or linezolid) for MRSA risk

 

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Respiratory quinolones--Levofloxacin, Moxifloxacin
2nd generation cephalosporins--Cefuroxime, Cefpodoxime