HEENT
     Otitis externa
          Initial treatment in otherwise healthy people
               Cipro/Dexamethasone otic <-can be used with perforated TM
               Ofloxacin otic <-can be used with perforated TM
          Secondary treatment
               Cipro/Hydrocortisone
               Neomycin/Polymyxin B/hydrocortisone otic
               Acetic acid otic
               Hydrocortisone/acetic acid otic
          Refractory to initial treatment
               Cipro PO AND ( Cipro/Dexamethasone otic OR Ofloxacin otic)
          Malignant or necrotizing, primary options
               As for refractory but add debridement
          Malignant or necrotizing, secondary options
               Cefepime
               Ticarcillin/clavulanate
               Piperacillin
               Imipenem/cilastatin
               Aztreonam
          Consider fungal etiology if treatment failure or dry/white appearance
     Otitis media, acute
          Delayed antibiotic therapy*, primary options   *an option in helathy patients 6 months or older with reliable follow-up, particularly patients who do not meet the diagnostic criteria or have a less certain diagnosis
               Amoxicillin
          Delayed antibiotic therapy, secondary options
               Amoxicillin/clavulanate
               Cefdinir
               Cefuroxime axetil
          Delayed antibiotic therapy, tertiary options
               Azithromycin
               Ceftriaxone
     Otitis media, chronic
          (Amoxicillin OR Bactrim) AND Prednisone
          Ceftazidime
     Otitis media, chronic, cholesteatoma
          Cipro
     Erythema migrans or Stage 1 Lyme Disease
          In children greater than 9 years old
               Doxycycline
          In children less than 9 years old
               Amoxicillin
          Alternatives for those who can't take Doxycycline or Amoxicillin
               Cefuroxime axetil
               Erythromycin
     Stage 3 Lyme Disease
          Ceftriaxone OR
          Penicillin G
     Scarlet fever
          Treatment of choice
               Penicillin V
          Alternatives
               Erythromycin
               Clindamycin          
      Cystic Fibrosis, acute pneumonia with coverage of P. aeruginosa (double-coverage is required), S. aureus and H. influenza
          First line
               IV Ceftazidime AND Gentamicin
               Ticarcillin AND Gentamicin
          Alternatives
               Cefepime
               Imipenem/cilastatin
          Upon culture results, coverage for Staphylococcus may be added
               Nafcillin
               Vancomycin

Anaerobic lung infection
     Clindamycin

Content on this page has not been checked for accuracy. The author's credentials have not been confirmed. Always use multiple peer-reviewed scholarly sources and good clinical judgement in your decision making.

The Compendium platform was created by David Kwinter, MD, CCFP(EM).

Dr. Kwinter is a Cayman Family Doctor. He runs a Family Medicine Clinic at Cayman Medical in George Town, Grand Cayman, Cayman Islands.