Acute
Recommended therapy (7 day duration)
Amoxicillin 500 mg PO TID
Penicillin allergic (rash)
Cefuroxime axetil 500 mg PO BID
Severe pen-allergy or cephalosporin allergy (e.g. anaphylaxis, angioedemia)
Clarithromycin 500 mg PO BID or TMP/SMX 1 DS tab PO BID
- 80% of uncomplicated cases in previously healthy individuals usually resolve within 3 days.
- S. pneumoniae susceptibility: Amoxicillin (98%), cefuroxime (92%), TMP/SMX (72%) & erythromycin (75%).
Complex or Chronic
Refer to BUGS & DRUGS OR Consult with Medical Microbiology / Infectious Disease and strongly consider an ENT consult.
- Failure of First-line Agents
- Persistent (greater than 7 days)
- Chronic
- Recurrences less than 6 weeks apart