

Deep Neck Space Infections
- These include peritonsillar abscess, Ludwig’s angina (submandibular space infection), parapharyngeal and retropharyngeal space infections.
- Infections are typically polymicrobial.
- Refer to Otolaryngology.
Pathogens
- Common: S. pyogenes, Viridans Streptococci, Peptostreptococcus
- Other: Actinomyces, Fusobacterium necrophorum, Aggregatabacter (Actinobacillus), Eikenella
Drug Treatment
- Duration: At least 10 days. Actinomyces infections require very prolonged therapy – consult Infectious Diseases/Clinical Microbiology.
Empiric
Mild penicillin allergy
- fe = 0.5, consider adjusting dose if CrCl reduced.
AND
- High oral availability – prescribe orally unless GI absorption is compromised or patient is nil by mouth.
- Metabolised by unknown pathways. (fe = 0.1).
Severe penicillin allergy
AND
- fe = 0.9, adjust dose if CrCl reduced.
- Must be given diluted (1 g in at least 200 mL) and slowly (≤ 1000 mg/hour) to minimise infusion reactions.
AND
- High oral availability – prescribe orally unless GI absorption is compromised or patient is nil by mouth.
- Metabolised by unknown pathways. (fe = 0.1).
Topic Code: 99224