{ "schema_version": 1, "kind": "condition", "id": "acute-lymphadenitis", "name": "Acute lymphadenitis", "category": "acute", "sources": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Cephalexin monograph (chapter PDF p220) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clindamycin monograph (chapter PDF p287) · Long M, Reddy DN, Akiki S, Barrowman NJ, Zemek R. Paediatric acute lymphadenitis: Emergency department management and clinical course. Paediatrics & Child Health. 2019 Sep 21;25(8):534-542. doi: 10.1093/pch/pxz125. PMCID: PMC7739529, PMID: 33354264.", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Cephalexin monograph (chapter PDF p220) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clindamycin monograph (chapter PDF p287) · Long M, Reddy DN, Akiki S, Barrowman NJ, Zemek R. Paediatric acute lymphadenitis: Emergency department management and clinical course. Paediatrics & Child Health. 2019 Sep 21;25(8):534-542. doi: 10.1093/pch/pxz125. PMCID: PMC7739529, PMID: 33354264.", "verified_date": "2026-08", "treatments": [ { "id": 64, "generic": "Cephalexin", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "250 to 1,000 mg every 6 hours, or 500 mg every 12 hours (maximum 4 g/day)", "adult_duration": "As directed (typically 7-10 days for a straightforward skin/lymph node infection)", "dose_source": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Cephalexin monograph (chapter PDF p220)", "rationale": "First-generation oral cephalosporin covering the Staphylococcus aureus and Streptococcus species that most often cause acute bacterial lymphadenitis; reasonable first oral choice in a Cairo GP setting.", "cautions": [ "Ask about penicillin allergy - cross-reactivity with cephalosporins is possible, especially with a history of a severe/anaphylactic penicillin reaction.", "Reduce the dose in significant renal impairment.", "If the node becomes fluctuant/abscessed, antibiotics alone will not resolve it - refer for incision and drainage.", "If the node is fixed, hard, and non-tender, or there is weight loss/night sweats or generalized lymphadenopathy, treat for infection but also investigate for malignancy or TB lymphadenitis rather than assuming a simple bacterial cause.", "Refer urgently for rapidly spreading redness or signs of systemic sepsis. TB lymphadenitis is common in Egypt - consider it for a persistent node with weight loss or night sweats." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Mild-to-moderate infection: 25 to 50 mg/kg/day divided every 6 or 12 hours, maximum 2,000 mg/day (a higher weight-based dose is given in the formulary for severe bone/joint infection, not usually needed for straightforward lymphadenitis).", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "AMTHROST 250 MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > SABAA", "price_egp": 4.0, "pack_count": 10, "unit_price": 0.4, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPHALEXIN 250MG 12CAPS. B.P.2000", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 5.28, "pack_count": 12, "unit_price": 0.44, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPHALEXCID 250MG 12CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CID", "price_egp": 6.43, "pack_count": 12, "unit_price": 0.54, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STARCEF 500MG 20 CAP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 18.0, "pack_count": 20, "unit_price": 0.9, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "STARCEF 1GM 12 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 20.4, "pack_count": 12, "unit_price": 1.7, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OSPEXIN 1000 MG 12 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE. > NOVARTIS", "price_egp": 28.8, "pack_count": 12, "unit_price": 2.4, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPOREX 1 GM 8 TABLETS", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 78.0, "pack_count": 8, "unit_price": 9.75, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEPOREX 250 MG/5ML SYRUP 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 23.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AMTHROST 125MG/5ML SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > SABAA", "price_egp": 4.0, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "AMTHROST 250MG/5ML SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > SABAA", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "acute-lymphadenitis" }, { "id": 65, "generic": "Clindamycin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "Oral: 150–300 mg every 6 hours.", "adult_duration": "As directed", "dose_source": "Egyptian National Drug Formulary - antimicrobial-2023.pdf, Clindamycin monograph (chapter PDF p287)", "rationale": "Alternative when there is penicillin/cephalosporin allergy or better anaerobic/skin-flora coverage is wanted; not first choice over cephalexin for straightforward lymphadenitis.", "cautions": [ "Risk of Clostridioides difficile-associated diarrhoea, which can occur weeks after stopping the drug - stop the drug and seek review for new, severe, or bloody diarrhoea.", "Use as an alternative when there is penicillin/cephalosporin allergy or concern for resistant/anaerobic organisms, not as a routine first choice over cephalexin.", "Caution in hepatic impairment.", "Same red flags as above - refer urgently if the node is fluctuant, spreading rapidly with signs of sepsis, or suspicious for malignancy/TB." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Oral: 8 to 20 mg/kg/day (hydrochloride capsule) or 8 to 25 mg/kg/day (palmitate solution) divided every 6 to 8 hours - general susceptible-infection dosing, not lymphadenitis-specific in this excerpt.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "ADCOCLINDACE 150 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 14.5, "pack_count": 16, "unit_price": 0.91, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALFACLINDAMYCIN 150 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA > ROTABIOGEN", "price_egp": 14.5, "pack_count": 10, "unit_price": 1.45, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ADCOCLINDACE 300 MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 24.0, "pack_count": 16, "unit_price": 1.5, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CLINACYN 300MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA > EGYPTIAN PHARMACISTS COMPANY", "price_egp": 31.5, "pack_count": 16, "unit_price": 1.97, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEPACLIND 150MG 16 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 48.0, "pack_count": 16, "unit_price": 3.0, "strength_mg": 150.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEPACLIND 300MG 8 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 38.0, "pack_count": 8, "unit_price": 4.75, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ALFACLINDAMYCIN 300 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ATCO PHARMA > ROTABIOGEN", "price_egp": 69.0, "pack_count": 10, "unit_price": 6.9, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DALACIN C 300MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 114.0, "pack_count": 10, "unit_price": 11.4, "strength_mg": 300.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "KLENDABIOTICAM 1 % TOP. SOLUTION", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PANAX PHARMA", "price_egp": 8.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ADCOCLINDACE 10MG/ML TOP. SOL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 10.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "acute-lymphadenitis" } ] }