Antimicrobial therapy in URTI

Condition Preferred drug Alternative Penicillin allergy

Streptococcal pharyngitis

Penicillin V (not easily available in India, Penicillin G not a substitute since oral absorption is poor

Amoxicillin
Benzathine penicillin single dose

Anaphylactic: clindamycin/ clarithromycin/ azithromycin
Non-anaphylactic: cephalexin/ cefadroxil

Bacterial sinusitis

Amoxicillin
Co-amoxiclav

Ceftriaxone
Cefpodoxime
(adults)

Adults: doxycycline/ resp quinolones
Children: Anaphylactic resp quinolones, Non-anaphylactic: cefixime and clindamycin

Acute otitis media

Amoxicillin
Co-amoxiclav

Cefpodoxime, cefuroxime, cefdinir, Ceftriaxone

Anaphylactic: azithromycin/ clarithromycin
Non-anaphylactic: cephalosporins