The presence beta-lactamase-producing anaerobic as well as aerobic bacteria, especially in individuals
who have recently received penicillin, is known to be high [22]. In these patients antimicrobials effective against these resistant organisms are indicated. These include clindamycin, the combination of a penicillin and a beta-lactamase inhibitor, or the combination of metronidazole and a macrolide. If no clinical improvement occurs after
36/48 h of therapy a reassessment of therapy is needed.