What is the treatment for Haemophilus influenzae (H. influenzae) infection in the throat?

From the Guidelines

Haemophilus influenzae infection in the throat should be treated with amoxicillin-clavulanate (Augmentin) as the first-line therapy, at a dose of 45 mg/kg/day divided into 3 doses for children, due to its effectiveness against beta-lactamase producing strains, as recommended by the most recent guidelines 1. The treatment of H. influenzae infection in the throat is crucial to prevent complications such as epiglottitis or pneumonia.

• The preferred oral therapy for H. influenzae infection is amoxicillin-clavulanate, which is effective against beta-lactamase producing strains, as stated in the guidelines 1.
• For patients with penicillin allergy, alternatives include cefuroxime, cefdinir, cefixime, cefpodoxime, or ceftibuten, as suggested by the guidelines 1.
• It is essential to note that H. influenzae produces beta-lactamase enzymes that can inactivate some antibiotics, which is why amoxicillin-clavulanate is preferred over amoxicillin alone, as highlighted in the study 1.
• Patients should complete the full course of antibiotics even if symptoms improve quickly, stay hydrated, and use over-the-counter pain relievers for throat discomfort.
• Follow-up with a healthcare provider is recommended if symptoms worsen or don't improve within 48-72 hours of starting antibiotics. The most recent study 1 provides the strongest evidence for the treatment of H. influenzae infection in the throat, and its recommendations should be followed to ensure the best possible outcome for patients.
• The study highlights the importance of using antibiotics that are effective against beta-lactamase producing strains, such as amoxicillin-clavulanate, to prevent treatment failure and reduce the risk of complications.
• The guidelines 1 also emphasize the need for prompt treatment to prevent complications and recommend the use of amoxicillin-clavulanate as the first-line therapy.

From the FDA Drug Label

1.1 Acute Bacterial Exacerbation of Chronic Bronchitis Clarithromycin extended-release tablets are indicated in adults for the treatment of mild to moderate infections caused by susceptible isolates due to Haemophilus influenzae, Haemophilus parainfluenzae, Moraxella catarrhalis,or Streptococcus pneumoniae 1.3 Community-Acquired Pneumonia Clarithromycin extended-release tablets are indicated for the treatment of mild to moderate infections caused by susceptible isolates due to: Haemophilus influenzae(in adults)

The treatment for Haemophilus influenzae (H. influenzae) infection in adults is clarithromycin extended-release tablets. The recommended dosage is 1 gram every 24 hours for 7 to 14 days, depending on the type of infection [ 2 ].

• Infection: Acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, or community-acquired pneumonia
• Dosage: 1 gram every 24 hours
• Duration: 7 to 14 days

From the Research

Treatment for Haemophilus influenzae Infection in the Throat

• The treatment for Haemophilus influenzae infection in the throat typically involves antibiotic therapy 3, 4, 5, 6, 7.
• For less severe infections, ampicillin or amoxicillin for 10 days may be satisfactory in the ambulatory setting 3.
• Cephalosporins, such as cefotaxime or ceftriaxone, are often chosen for treatment of adults with pneumonia when Haemophilus influenzae is documented 3.
• Third-generation cephalosporins, such as ceftriaxone, may be the preferred treatment option for infections caused by ampicillin-resistant H. influenzae 5.
• Sultamicillin, a compound agent that combines ampicillin and the beta-lactamase inhibitor sulbactam, has been shown to be effective in treating persistent lower respiratory tract infections caused by Haemophilus influenzae 6.

Antibiotic Resistance

• Haemophilus influenzae isolates have shown reduced susceptibility to certain antibiotics, including ampicillin, sulfamethoxazole-trimethoprim, and azithromycin 4, 5.
• The resistance rate of ampicillin and azithromycin in H. influenzae has been increasing over time 5.
• Beta-lactamase-negative ampicillin-resistant (BLNAR) isolates are less common, but have been associated with ftsI mutations 4.
• More than 90% of H. influenzae isolates are susceptible to ceftriaxone, cefotaxime, meropenem, levofloxacin, and chloramphenicol 5.

Treatment Considerations

• The choice of antibiotic therapy should be guided by knowledge of bacterial susceptibility and microbiologic efficacy 7.
• Clinicians should be aware of the increasing trend of resistance to certain antibiotics and adjust their treatment strategies accordingly 4, 5.
• Supportive therapy is also critical in the management of Haemophilus influenzae infections, particularly in severe cases 3.