From the Research
The treatment for epiglottitis requires immediate hospitalization and airway management as the top priority, with a focus on securing the airway through intubation or tracheostomy if severe airway obstruction is present, as supported by the most recent study 1. Patients should be taken to an emergency department where specialists can secure the airway. Intravenous antibiotics are essential and typically include ceftriaxone or ampicillin-sulbactam for 7-10 days to target common causative organisms like Haemophilus influenzae type B, Streptococcus pneumoniae, and Staphylococcus aureus. Corticosteroids such as dexamethasone may be administered to reduce inflammation and swelling, as seen in a case study 2. Patients require close monitoring in an intensive care setting with equipment for emergency airway intervention readily available. Humidified oxygen should be provided to maintain adequate oxygenation. It's crucial not to agitate the patient or attempt throat examination with a tongue depressor, as this could trigger complete airway obstruction. Epiglottitis is life-threatening because the inflamed epiglottis can rapidly swell and completely block the airway, which is why aggressive and prompt treatment is necessary to prevent respiratory failure and death, as highlighted in a retrospective review of 106 patients 3.
Some key points to consider in the treatment of epiglottitis include:
- The importance of early airway management, as delayed intervention can lead to increased morbidity and mortality 4
- The use of intravenous antibiotics to target common causative organisms, with ceftriaxone being a commonly recommended option 5
- The potential benefits of corticosteroids in reducing inflammation and swelling, although the evidence for this is not as strong 2
- The need for close monitoring in an intensive care setting, with equipment for emergency airway intervention readily available 1
Overall, the treatment of epiglottitis requires a multidisciplinary approach, with a focus on securing the airway, administering intravenous antibiotics, and providing close monitoring and supportive care. The most recent study 1 supports the use of aggressive and prompt treatment to prevent respiratory failure and death.