GuidelinesEML (Adult Hospital STG)
Epiglottitis
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition
ICD-10 Code: J05.1
DESCRIPTION
- Acute epiglottitis can result in severe, sudden or progressive airway obstruction.
- Acute epiglottitis can be caused by bacteria (e.g. H. influenzae), viruses (e.g. herpes simplex) and non-infectious insults (trauma, chemicals, heat).
GENERAL MEASURES
- Airway management may require urgent specialist advice.
- Adequate hydration.
MEDICINE TREATMENT
- Humidified oxygen.
Antibiotic therapy
Total duration of therapy: 10 days
- Ceftriaxone, IV, 1 g daily.
Follow with oral therapy as soon as patient can swallow and the temperature is <37.8o C for 24 hours, to complete the 10-day course:
- Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly.
Severe penicillin allergy to amoxicillin/clavulanic acid, oral: (Z88.0)
- Macrolide, e.g.:
- Azithromycin, oral, 500 mg daily for 3 days.
Acute stage
Imminent airway obstruction:
- Hydrocortisone, IV, 100 mg immediately as a single dose.
AND
- Adrenaline (epinephrine) 1:1 000, 1 mL nebulised.
- Dilute to 5 mL with sodium chloride 0.9% and administer 4–6 hourly.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2024 Edition