Ongoing intravenous therapy for septic jugular thrombophlebitis

For septic jugular thrombophlebitis (including infection associated with lung abscess), modify therapy as soon as additional information is available (eg results of Gram stain, culture and susceptibility testing).

If gram-positive cocci in clusters are identified by Gram stain of a blood sample, see Staphylococcus aureus bacteraemia, including sepsis and septic shock. If Staphylococcus aureus is not identified, stop vancomycin.

If an anaerobic pathogen (eg Fusobacterium necrophorum) is identified in blood samples taken for culture, the infection is often polymicrobial. For ongoing intravenous therapy for patients with septic jugular thrombophlebitis (including patients with associated lung abscess) due to anaerobic pathogens, suitable regimens include:

• amoxicillin+clavulanate in adults
• ceftriaxone or cefotaxime plus metronidazole (for regimens, see adults or children)
• clindamycin in adults and children.