Which medications in the drug class Antibiotics are used in the treatment of Epiglottitis?

Updated: Apr 28, 2020
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

Antibiotics

Empiric coverage for Streptococcus pyogenes, Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae should be provided (a third-generation cephalosporin or amoxicillin/clavulanic acid) in the management of epiglottitis. Third-generation cephalosporins are preferred as first-line agents because of increasing resistance to ampicillin.

Ceftriaxone (Rocephin)

Ceftriaxone is the antibiotic of choice (DOC) for epiglottitis. This agent is a third-generation cephalosporin with broad-spectrum activity against gram-negative organisms, lower efficacy against gram-positive organisms, and higher efficacy against resistant organisms. By binding to one or more penicillin-binding proteins, ceftriaxone arrests bacterial cell wall synthesis and bacterial growth.

Ampicillin and sulbactam (Unasyn)

Ampicillin with sulbactam is the drug combination of a beta-lactamase inhibitor with ampicillin. This combination interferes with bacterial cell wall synthesis during active replication, causing bactericidal activity against susceptible organisms.

Ampicillin with sulbactam is used as an alternative to amoxicillin when the patient is unable to take medication orally. This combination covers skin, enteric flora, and anaerobes but is not ideal for nosocomial pathogens.

Chloramphenicol

Chloramphenicol is used if patients are allergic to penicillin and cephalosporins. This agent binds to the 50S bacterial-ribosomal subunits and inhibits bacterial growth by inhibiting protein synthesis. Chloramphenicol is effective against gram-negative and gram-positive bacteria.

Cefuroxime (Zinacef, Ceftin)

Cefuroxime is a second-generation cephalosporin antibiotic with activity against gram-positive and some gram-negative bacteria, including Haemophilus influenzae. Cefuroxime binds to penicillin-binding proteins and inhibits the final transpeptidation step of peptidoglycan synthesis, resulting in cell wall death.

Cefotaxime (Claforan)

Cefotaxime is another third-generation cephalosporin antibiotic with broad-spectrum activity against gram-positive and gram-negative bacteria. This agent binds to penicillin-binding proteins and inhibits the final transpeptidation step of peptidoglycan synthesis, resulting in cell wall death.

Clindamycin (Cleocin)

Clindamycin is a semisynthetic antibiotic produced by the 7(S)-chloro-substitution of the 7(R)-hydroxyl group of the parent compound lincomycin. This agent inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest. Clindamycin widely distributes in the body, without penetration of the central nervous system. This agent is protein bound and excreted by the liver and kidneys.


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