Emergent ENT or OMFS consult for operative I&D and extraction of dentition if source is dental abscess
Intubation may be very difficult due to trismus and posterior pharyngeal extension
Preference for an awake fiberoptic intubation (ideally in OR if time allows) with setup immediately available for cricothyrotomy
Must cover typical polymicrobial oral flora and tailored based on patient's immune status
Most commonly a 3rd generation cehpalosporin + (clindamycin or metronidazole)
If the patient is immuncompromised, the antibiotics need to also cover MRSA and gram-negative rods
Ampicillin/Sulbactam 3g (50mg/kg) IV q6 hrs OR
Penicillin G 2-4 million units IV q6 hrs + Metronidazole 500 mg IV q6 hrs OR
Clindamycin 600 mg IV q6 hrs (option for those allergic to penicillin)
Cefepime 2 g IV q12 hrs + Metronidazole 500 mg IV q6 hrs OR
Meropenem 1 g IV q8 hrs OR
Imipenem/Cilastatin 500mg (20mg/kg) IV q6 hours
Piperacillin-tazobactam 4.5g (80mg/kg) IV q6 hours
Add Vancomycin 15-20 mg/kg IV q8 hrs (max 2 g per dose) if concern for MRSA risk factors
Ludwig's angina
Streptococcal pharyngitis 
CMV esophagitis
Neisseria gonorrhoeae
Peritonsillar cellulitis
Diphtheria 
Esophageal candidiasis
Bacterial Tracheitis