- Haemophilus influenzae type b
- Streptococcus pneumoniae
- Streptococcus pyogenes
- Staphylococcus aureus
First-line therapy
Ceftriaxone • i.v. • 50–50 mg/kg/day • 1×/day
Max 2000 mg/day · Duration: 7–10 days · Continue IV until clinically stable; step down when appropriate
Enter weight on Kids to calculate doses
Ampicillin/sulbactam • i.v. • 200–200 mg/kg/day • 4×/day
Dose is calculated using the ampicillin component.
Max 8000 mg/day · Duration: 7–10 days · Ampicillin component dosing per international guidelines
- • Polymicrobial infection or beta-lactamase–producing organisms suspected
- • Ceftriaxone or cefotaxime allergy or intolerance
- • Alternative per local ICU or ENT protocol
- • Add MRSA coverage per local epidemiology if indicated
Clinical notes
- • Airway management has absolute priority.
- • Do not force throat examination.
- • Prepare for difficult airway.
- • Antibiotics should not delay airway stabilization.
- • Early ENT/anesthesia consultation.
- • ESPID Guideline (2024)
- • AAP Red Book — Epiglottitis (2024)
- • NICE NG51 — Croup and Acute Upper Airway Obstruction (2017)
