Indications for Abx in acute rhionsinusitis
First line Rx
-persistent symptoms for more than 10 days
-onset of severe symptoms or signs of high fever (>39 °C) and purulent nasal discharge -facial pain lasting for at least 3 consecutive days
-onset of worsening symptoms following a typical viral illness that lasted 5 days that was initially improving (double sickening).
Amoxicillin or augmenting for 5-10 days. Doxy if penicillin allergy. Resp FQ last resort
Abx in strep throat
reduce the duration of symptoms and the risk of suppurative complications (e.g., acute otitis media, peritonsillar abscess) and acute rheumatic fever, but antibiotics have not been shown to prevent poststreptococcal glomerulonephritis.
Lemierre’s syndrome is characterized by disseminated abscesses and thrombophlebitis of the internal jugular vein after infection of the oropharynx. The predominant pathogen is a gram-negative anaerobic bacillus Fusobacterium necrophorum. Rx is clindamycin, flagyl and enoxaparin