This protocol covers the management of retropharyngeal abscess in a patient with a documented prior anaphylactic reaction to penicillin. The standard penicillin-based or beta-lactam antibiotic regimen is contraindicated, requiring a modified treatment strategy.
A history of anaphylaxis to penicillin determines antibiotic selection. The protocol specifies which intravenous antibiotic is used in place of penicillin/beta-lactam, along with the conditions under which parenteral therapy may subsequently be transitioned to an oral agent.
Immediate priorities include airway assessment — with endotracheal intubation or emergency tracheostomy if the airway is compromised — alongside hydration and analgesia. An intravenous antibiotic is given as an alternative to the penicillin-based regimen; when appropriate, this may later be transitioned to oral therapy. The complete antibiotic selection, sequencing criteria, and transition rules are available in the full protocol.
Clinical target: Clinical improvement within 48 hours of initiating intravenous antibiotic therapy.