14. Ear, nose and throat

Infection	IV treatment	Oral treatment	Duration
Dental Infections	.	Amoxicillin 250 - 500mg tds In penicillin allergy Metronidazole 400mg tds	3-7 days depending on severity
Sinusitis	.	Amoxicillin 250 - 500mg tds (first choice) In penicillin allergy Doxycycline 200mg stat, then 100mg od or Clarithromycin 500mg bd	Treat for 7-10 days. Chronic infections may require up to 14 days treatment
Oral Candidiasis	.	Nystatin suspension 1ml qds or Fluconazole 50mg daily	Treat for 7 days or continue for 48 hours after lesions have healed.
Otitis Media	.	Amoxicillin 250 - 500mg tds In penicillin allergy Clarithromycin 500mg bd	5 days
Tonsillitis	Most infections are viral and antibiotics are unnecessary. In severe infection IV benzylpenicillin 1.2g qds initially In penicillin allergy Clarithromycin 500mg bd	Penicillin V 500mg qds increased to 750mg qds in severe infections. In penicillin allergy Clarithromycin 500mg bd	10 days
Epiglottitis	Ceftriaxone IV 2g BD*	Co-Amoxiclav 625mg tds In penicillin allergy Ciprofloxacin 500mg bd	10 days
Quinsy & allied syndromes	IV Co-amoxiclav 1.2g tds* plus metronidazole 500mg tds In penicillin allergy Ciprofloxacin 400mg bd*	Co-amoxiclav 625mg plus metronidazole 400mg tds In penicillin allergy Ciprofloxacin 500mg bd	10 days

*For patients with renal impairment refer to section 23 for dosage adjustments