When to prescribe abx for acute rhinosinusitis
sx >10 days, high fever (>39C) + puruluent nasal discharge, facial pain ongoing for >3 days consecutivelyl, double sickening
Rarer throat infections
Peritonsilar abscess, epiglottitis, Lemierre syndrome
Scoring tools for strep pharyngitis
Centor
McIsaac
Treatment for strep pharyngtitis
Penicillin V or amoxicillin for 10 days
Penicillin G (once IM)
Cough with URI
Post nasal drip
Acute bronchitis
Cough without focal lung finding. Purulent sputum result of sloughing of TB inflammatory cells/ epithelium.
When patients with chronic obstructive pulmonary disease present with bronchitic exacerbations (e.g., increasing volume and purulence of sputum), antibiotic therapy recommended is:
For uncomplicated cases, doxycycline, macrolides, cephalosporins, or trimethoprim–sulfamethoxazole are acceptable options.
Acute rhinosinusitis bacterial treatment
Augmentin x5-7 days, high dose (2g bid) for those with risk factor for resistance or sever infection (elderly, recent abx, immunocomprosmised, high fever)
