Chapter 5: Infections
Page Areas of Interest
263 Notifiable diseases – Table
Proper Officer of the local authority should be notified by doctor
265-267 Table 1: Summary of antibacterial therapy
267-269 Table 2: Summary of antibacterial prophylaxis
268 Advice from the Working Party of the British Society for Antimicrobial Chemotherapy
re dental and dermatological procedures
Antibiotic prophylaxis is not required for:
1. For dental treatment in patients with prosthetic joint implants
2. Patients undergoing dermatological procedures against endocarditis
3. For dental treatment in patients immunosupressed or with indwelling
intraperitoneal catheters
269 5.1.1 Penicillins
Main S.E. = hypersensitivity (1-10%) anaphylaxis (0.05%)
Renal excretion
Injectable penicillins contain either sodium or potassium
271 CSM warning - Flucloxacillin and occurrence of hepatic disorders
cholestatic jaundice may occur up to several weeks after treatment stopped; administration
for longer 2 weeks and increasing age are risk factors
275 5.1.2 Cephalosporins
Broad-spectrum septicaemia, pneumonia, meningitis, biliary tract infections,
peritonitis, UTIs
10% of penicillin-sensitive patients will be allergic to cephalosporins
281 5.1.3 Tetracyclines
C.I. children <12 years (deposition in bones and teeth), pregnancy, breast-
feeding,
Antacids, Al, Ca, Zn, Mg, Fe decrease absorption of tetracyclines
Milk decreases absorption of demeclocycline, oxytetraceycline and tetracycline
283 5.1.4 Aminoglycosides
Not absorbed from the gut
Should not be given with ototoxic diuretics (eg furosemide). If unavoidable
separate by as long period as practicable
Monitor (normal renal function) – 3-4 dose 1 hour after administration and
before next dose (for levels see individual drug monographs)
285 5.1.5 Macrolides
Similar spectrum of activity to penicillins alternative in penicillin allergic
patients
287 5.1.6 Clindamycin
Serious toxic effect more frequent - ANTIBIOTIC-ASSOCIATED COLITIS
discontinue treatment immediately if diarrhoea develops
288 5.1.7 Other antibacterials
1. Chloramphenicol – potent but serious haematological SE when given systemically.
Page Areas of Interest
263 Notifiable diseases – Table
Proper Officer of the local authority should be notified by doctor
265-267 Table 1: Summary of antibacterial therapy
267-269 Table 2: Summary of antibacterial prophylaxis
268 Advice from the Working Party of the British Society for Antimicrobial Chemotherapy
re dental and dermatological procedures
Antibiotic prophylaxis is not required for:
1. For dental treatment in patients with prosthetic joint implants
2. Patients undergoing dermatological procedures against endocarditis
3. For dental treatment in patients immunosupressed or with indwelling
intraperitoneal catheters
269 5.1.1 Penicillins
Main S.E. = hypersensitivity (1-10%) anaphylaxis (0.05%)
Renal excretion
Injectable penicillins contain either sodium or potassium
271 CSM warning - Flucloxacillin and occurrence of hepatic disorders
cholestatic jaundice may occur up to several weeks after treatment stopped; administration
for longer 2 weeks and increasing age are risk factors
275 5.1.2 Cephalosporins
Broad-spectrum septicaemia, pneumonia, meningitis, biliary tract infections,
peritonitis, UTIs
10% of penicillin-sensitive patients will be allergic to cephalosporins
281 5.1.3 Tetracyclines
C.I. children <12 years (deposition in bones and teeth), pregnancy, breast-
feeding,
Antacids, Al, Ca, Zn, Mg, Fe decrease absorption of tetracyclines
Milk decreases absorption of demeclocycline, oxytetraceycline and tetracycline
283 5.1.4 Aminoglycosides
Not absorbed from the gut
Should not be given with ototoxic diuretics (eg furosemide). If unavoidable
separate by as long period as practicable
Monitor (normal renal function) – 3-4 dose 1 hour after administration and
before next dose (for levels see individual drug monographs)
285 5.1.5 Macrolides
Similar spectrum of activity to penicillins alternative in penicillin allergic
patients
287 5.1.6 Clindamycin
Serious toxic effect more frequent - ANTIBIOTIC-ASSOCIATED COLITIS
discontinue treatment immediately if diarrhoea develops
288 5.1.7 Other antibacterials
1. Chloramphenicol – potent but serious haematological SE when given systemically.
