Which medications in the drug class Antibiotics are used in the treatment of Peritonsillar Abscess in Emergency Medicine?

Updated: Sep 03, 2020
  • Author: Jorge Flores, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

Antibiotics

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.

Clindamycin (Cleocin)

Semisynthetic antibiotic produced by 7(S)-chloro-substitution of 7(R)-hydroxyl group of parent compound lincomycin. Inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest. Widely distributes in the body without penetration of CNS. Protein bound and excreted by the liver and kidneys.

Oral or parenteral antibiotic for anaerobic or susceptible streptococcal, pneumococcal, or staphylococcal species. Considered to have good absorption into bloodstream in both oral and parental forms.

Penicillin G benzathine (Bicillin L-A)

DOC in combination with metronidazole. Effective in approximately 98% of patients. Interferes with synthesis of cell wall mucopeptide during active multiplication, resulting in bactericidal activity against susceptible microorganisms.

Metronidazole (Flagyl)

DOC in combination with penicillin. Effective in approximately 98% of treated patients.

Imidazole ring-based antibiotic active against various anaerobic bacteria and protozoa. Appears to be absorbed into the cells of microorganisms that contain nitroreductase. Unstable intermediate compounds are formed that bind DNA and inhibit synthesis, causing cell death.

Nafcillin (Unipen)

Initial therapy for suspected penicillin G-resistant streptococcal or staphylococcal infections.

Use parenteral therapy initially in severe infections. Change to PO therapy as condition warrants.

Because of thrombophlebitis, particularly in elderly persons, administer parenterally only for short term (1-2 d); change to PO route as clinically indicated.

Erythromycin (E.E.S, Ery-Tab, Erythrocin)

Inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest. For treatment of staphylococcal (including S aureus) and streptococcal infections.

Indicated if patient is allergic to penicillin.


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