Therapy is determined by the patient's condition. In unilateral masticator space infections, airway compromise is rare; however, the possibility should always be considered. Emergent ear, nose, and throat (ENT) consultation is required in patients with airway compromise, severe trismus, vomiting, palpable abscess, large or diffuse areas of cellulitis, large areas of induration, or systemic signs of sepsis.
For patients requiring hospitalization, intravenous antibiotics should be started in the ED. Large doses of penicillin, 20 million units daily, are appropriate. In penicillin-allergic patients, clindamycin is a good alternative. 2i6 Analgesics should be administered as needed.
In candidates for outpatient management, antibiotic selection is as follows: penicillin as a first choice, erythromycin, or clindamycin may be selected. Antibiotics should be continued for 10 to 14 days.
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