Parapharyngeal abscess is a deep neck space infection that requires prompt assessment and timely intervention. When the patient has a documented history of anaphylaxis to penicillin, the standard antibiotic approach must be reconsidered — the choice of therapy becomes a critical clinical decision.
This protocol addresses patients with parapharyngeal abscess who have experienced a previous anaphylactic reaction to penicillin. The allergy history rules out penicillin-class agents entirely and drives the selection of an alternative antibiotic strategy.
Management begins with evaluation and stabilisation of the airway. Antibiotic therapy is then selected to avoid penicillin — a specific alternative is used, with a transition from one administration route to another as the patient improves. The complete regimen is detailed in the full protocol.
Clinical improvement within 48 hours of the initiation of intravenous antibiotic therapy.
Evaluation and treatment of respiratory problems is the first step, to which all the experts agree.
Patients with previous anaphylactic reactions to penicillin may be treated with clindamycin.
Moreover, when a patient improves, parenteral therapy may be switched to oral therapy with the same drug(s) if available or with drugs with a similar spectrum of activity.
no clinical improvement after 48 hours from the initiation of i.v antibiotic therapy
DOI: 10.3390/children9050618
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