What are the recommended antibiotic regimens for treating epiglottitis in children and adults?

Recommended antibiotic regimens for treating epiglottitis in children and adults:

• Epiglottitis is most commonly caused by Haemophilus influenzae type b and other bacteria, requiring prompt intravenous antibiotic treatment.
• The first-line treatment is intravenous ceftriaxone at the highest doses recommended by the British National Formulary for Children (BNFC) or British National Formulary (BNF), depending on patient age and weight.
• If ceftriaxone is contraindicated, intravenous cefotaxime is an alternative, especially in pre-term babies under 41 weeks corrected gestational age.
• In cases of severe allergy to cephalosporins, alternative regimens include co-trimoxazole combined with chloramphenicol, guided by specialist advice.
• Empirical treatment should cover Haemophilus influenzae and other common pathogens, with adjustments based on microbiological results and clinical response.
• Early administration of intravenous antibiotics is critical, ideally as soon as epiglottitis is suspected, to reduce morbidity and mortality.

These recommendations align with the NICE guideline on bacterial meningitis and meningococcal disease management, which includes epiglottitis as a severe bacterial infection requiring similar antibiotic coverage and urgency ².