antibiotic guidelines

antibiotic guidelines



Table Of Contents

Feb 24, 2021 | Chemical Pathology

Antimicrobial stewardship: From theory to practice...

Antimicrobial Stewardship

Feb 23, 2021 | Chemical Pathology

Antimicrobial resistance (AMR) has increased worldwide to the extent that it is now regarded as a global public health crisis. In this regard, the emergence and rapid spread of extensive drugresistant (XDR), including carbapenemase-producing Gram-negative bacteria (GNB) in South Africa, is of particular concern....

Chapter 1 - Prescribing Antimicrobial General Principles

Feb 04, 2021 | Chemical Pathology

The rational use of antimicrobials is a key element in developing a successful strategy against the development of resistance to antimicrobials. The physician should establish the need and the reason for therapy, select the appropriate antimicrobial agent, and then decide on the optimum dose and dosing interval, duration, as well as route of administration....

Chapter 2 - Notes On Selected Antibiotics

Feb 03, 2021 | Chemical Pathology

This important group of cell wall-active antibiotics includes the penicillins, cephalosporins, carbapenems, monobactams, and some ß-lactamase inhibitors. They all contain an active ß-lactam ring in their chemical structure from which their collective name is derived....

Chapter 3 - Antimicrobial Use In Pregnant And Breastfeeding Patients

Feb 02, 2021 | Chemical Pathology

Antimicrobial agents administered to pregnant women may be harmful to the developing foetus. The major period of danger for teratogenic effects is during the first trimester, although some drugs can interfere with the functional development of organ systems and the central nervous system in the second and third trimester, and have serious consequences....

Chapter 4 - Pre-Exposure And Post-Exposure Prophlaxis

Feb 01, 2021 | Chemical Pathology

Maternal colonisation is the single most important risk factor for early onset group B streptococcal (GBS) infection....

Chapter 5 - Antibiotic Prophylaxis For Surgical Procedures

Jan 31, 2021 | Chemical Pathology

Surgical site infections (SSIs) are a common cause of healthcare-associated infection. The CDC has defined a SSI as an infection related to an operative procedure that occurs at or near the surgical incision within 30 days of the procedure, or within 90 days if prosthetic material is implanted at surgery....

Chapter 6 - Antibiotic Prophylaxis For Non Surgical Procedures

Jan 30, 2021 | Chemical Pathology

The European Society of Cardiology guidelines (ESC 2015) limit antibiotic prophylaxis to patients who have the highest risk of infective endocarditis (IE) undergoing high-risk dental procedures. The ESC highlights the importance of oral and cutaneous hygiene measures. They have also recognised that there is an increase in IE due to staphylococci and an increase in healthcare associated IE, thereby highlighting the importance of non-specific infection prevention measures....

Chapter 7 - Central Nervous System Infections

Jan 29, 2021 | Chemical Pathology

Bacterial meningitis is a serious, life-threatening disease that results in high morbidity and mortality. The classical triad of acute bacterial meningitis consists of fever, neck stiffness, and change in mental status (e.g. confusion, lethargy)....

Chapter 8 - Eye Infections

Jan 28, 2021 | Chemical Pathology

Most superficial infections are benign and can be adequately managed in the community. However, in certain predisposed individuals, infection can be severe, prolonged and potentially sight-threatening. Such patients include contact lens wearers, immunocompromised patients and those in whom the natural defences of the eye have been breached (via disease process or trauma, including surgery). These infections need to be treated in a specialist unit. Organisms involved may be commensals or exogenous (bacteria, viruses, fungi and intracellular parasites)....

Chapter 9 - Ear, Nose, And Throat Infections

Jan 27, 2021 | Chemical Pathology

Signs and symptoms include ear pain (otalgia), ear discharge, hearing loss, fever, lethargy or irritability. Vertigo, nystagmus and tinnitus may occur. Redness of the tympanic membrane is an early sign of otitis media, but erythema alone is not diagnostic of middle ear infection. In recurrent AOM, the use of tympanocentesis to identify the bacterial pathogen and susceptibility pattern may be necessary for choosing the most effective antibiotic....

Chapter 10 - Lower Respiratory Tract Infections

Jan 26, 2021 | Chemical Pathology

Acute bronchitis in otherwise healthy individuals is extremely common....

Chapter 11 - Infective Endocarditis

Jan 25, 2021 | Chemical Pathology

Risk factors for infective endocarditis (IE) include cardiac risk factors (prior infective endocarditis, presence of a prosthetic valve or cardiac device, history of valvular or congenital heart disease) and non-cardiac risk factors (intravenous drug use, intravenous lines, immunosuppression, recent dental or surgical procedure)....

Chapter 12 - Gastrointestinal Tract Infections

Jan 24, 2021 | Chemical Pathology

Helicobacter pylori is a bacterium that is found in the gastric mucous layer or adherent to the epithelial lining of the stomach. It is a common cause of gastric and duodenal ulcers. Its route of transmission remains unknown but current data suggests a faecal-oral route. The organism’s urease enzyme, motility and ability to adhere to gastric epithelium are factors that enable the organism to survive and proliferate in the gastric milieu. Recent adult European guidelines (Maastricht 2016) describe H. pylori as a cause of chronic active gastritis in all colonised adult patients....

Chapter 13 - Laboratory Diagnosis Of Urinary Tract Infection

Jan 23, 2021 | Chemical Pathology

A diagnosis of a urinary tract infection (UTI) is based on the patient’s history, physical examination and laboratory investigations. Overuse of antibiotics for the empiric management of patients with UTIs has resulted in many uropathogens developing resistance to common antibiotics. Management of UTIs needs a clear plan that considers the patient’s age and other factors such as pregnancy, complications and symptom recurrence. Since the sensitivities of uropathogens have become much less predictable, urine culture to identify the causative uropathogen and performing susceptibility testing has become mandatory in the management of all UTIs, especially in the case of ‘complicated UTIs’....

Chapter 14 - Treatment Of Urinary Tract Infections

Jan 21, 2021 | Chemical Pathology

Bacterial infections of the urinary tract are the most common cause of both community- and hospital-acquired infections....

Chapter 15 - Genital Tract Infections

Jan 20, 2021 | Chemical Pathology

The goals of therapy for sexually transmitted infections (STIs) include the elimination of the causative pathogen, resolution of the lesions and the symptoms, reduction in the risk of transmission, prevention of complications and if applicable, a reduction in the frequency of recurrences. Always take a comprehensive history, including a sexual history and examine the patient carefully. Always perform counselling and testing for HIV, hepatitis B and C and discuss and provide contraception including condoms....

Chapter - 16 Bone And Joint Infections

Jan 19, 2021 | Chemical Pathology

Osteomyelitis refers to an infection of bone that is usually bacterial in origin. There are three types of osteomyelitis depending on how the microorganisms were introduced into the bone....

Chapter 17 - Skin And Soft Tissue Infections

Jan 18, 2021 | Chemical Pathology

Skin and soft tissue infections range from mild to severe infections. Systemic involvement may occur and is dependent on the virulence of the organism, host factors (immunity and site of injury), and the severity of the injury....

Chapter 18 - Systemic Bacterial Syndromes

Jan 17, 2021 | Chemical Pathology

Brucellosis is a zoonotic infection transmitted to humans by contact with fluids from infected animals (sheep, cattle, goats, pigs or other animals) or derived food products such as unpasteurised milk and cheese. High risk persons include veterinarians, farmers, meat handlers and abattoir workers. Several species are recognised within the genus Brucella, although most human cases of Brucellosis are caused by Brucella melitensis....

Chapter 19 - Sepsis And Septic Shock

Jan 16, 2021 | Chemical Pathology

Sepsis is the leading cause of death from infection and its reported incidence is on the rise. Mortality rates from sepsis are higher than heart attacks, strokes or trauma. Sepsis needs to be viewed with the same urgency as these other life-threatening conditions and early, effective treatment can significantly decrease mortality. For each hour antibiotics are delayed, survival in patients with septic shock is decreased by ~7.6%....

Chapter 20 - Antifungal Therapy

Jan 15, 2021 | Chemical Pathology

Amphotericin B is a polyene antifungal drug that is both fungistatic and fungicidal depending on the concentration at the infection site and the susceptibility of the pathogen. It acts by binding to sterols, primarily ergosterol in the fungal cell membrane of susceptible fungi with a resultant change in membrane permeability which allows leakage of intracellular components....

Chapter 21 - Treatment Of Common Fungal Infections

Jan 15, 2021 | Chemical Pathology

Aspergillus spp. have emerged as an important cause of life-threatening infections in immunocompromised patients, including those with prolonged neutropenia, advanced HIV infection, primary immunodeficiency and patients who have undergone haematopoietic stem cell transplantation or lung transplantation. Three forms of aspergillosis exist: invasive aspergillosis, chronic (saprophytic) aspergillosis, and allergic forms of aspergillosis....

Chapter 22 - Common Worm Infestations In SA

Jan 14, 2021 | Chemical Pathology

Ascaris lumbricoides is the largest intestinal nematode (roundworm) that infects humans and is one of the most common helminth infections globally. Ascaris suum is a roundworm parasite of pigs and can infect humans. It has become more prevalent in areas where exposure to pigs enables ingestion of infectious eggs. Use of pig faeces for fertilizer has increased its transmission. Clinical infection is similar to A. lumbricoides....

Chapter 23 - Malaria Diagnosis, Prevention, And Treatment

Jan 13, 2021 | Chemical Pathology

There are five Plasmodium species that are known to infect humans. In South Africa malaria is endemic in the north-eastern reaches of the three provinces of KwaZulu-Natal, Limpopo and Mpumalanga. The risk of infection peaks during the summer rainfall season, typically between September and May. The predominant malaria species in South Africa is Plasmodium falciparum, transmitted by Anopheles mosquitoes. Neighbouring countries such as Zimbabwe and Mozambique also have malaria-endemic areas and are an important source of imported malaria into South Africa....

Chapter 24 - Laboratory Diagnosis Of Mycobacterial Infections

Jan 12, 2021 | Chemical Pathology

Consider tuberculosis (TB) as part of the differential diagnosis of selected patients, especially those with respiratory tract infections, lymphadenopathy, fever of unknown origin, night sweats and weight loss to avoid delays in the diagnosis and inappropriate treatment. Staining for acid fast bacilli thus forms part of routine sputum microscopy, culture and sensitivity testing (MC&S). Specific laboratory tests for mycobacterial infection should be ordered, e.g. TB culture and TB polymerase chain reaction (PCR), if TB is clinically suspected....

Chapter 25 - Treatment Of Mycobacterial Infections

Jan 11, 2021 | Chemical Pathology

The goals of Tuberculosis (TB) drug treatment include: curing the patient of TB, preventing death from both active TB and its late effects, preventing TB relapse and recurrent disease, preventing the development of drug resistance, and reducing the risk of TB transmission to others....

Chapter 26 - Diagnosis And Treatment Of Common Viral Infections

Jan 10, 2021 | Chemical Pathology

Herpes simplex virus type 1 (HSV-1) accounts for most oral, labial and ocular infections and HSV-2 for most genital infections, although there is considerable overlap in these distributions....

Chapter 27 - Management Of HIV Infection In Adults

Jan 09, 2021 | Chemical Pathology

There are a number of HIV diagnostic algorithms in use today. The choice of algorithm used depends on a number of factors including cost, seroprevalence of HIV in the population being tested, and access to specialised laboratory tests. Algorithms using only ELISA or rapid tests for HIV antibodies run the risk of false positive results....

Chapter 28 - Management Of HIV Infection In Children

Jan 08, 2021 | Chemical Pathology

The following guidelines are not intended to be a comprehensive overview of managing HIV infected neonates, infants and children, but rather to give an overview of some of the key aspects of managing HIV in this age group. For more detailed information, a variety of guidelines are available – both local and international. Treating HIV infection in neonates, infants and children is a specialised field and should only be undertaken by those suitably trained and with sufficient experience....

Chapter 29 - An Approach To Pyrexia Of Unknown Origin

Jan 06, 2021 | Chemical Pathology

Defined as a temperature higher than 38.30C for more than three weeks, with no obvious source despite appropriate investigation. This strict definition prevents common and self-limiting medical conditions, especially acute viral illnesses, from being included as a cause of PUO....

Chapter 30 - An Approach To Antibiotic Allergies

Jan 05, 2021 | Chemical Pathology

Many patients experience adverse reactions to drugs, but most of these are predictable, dose dependent and do not involve the immune system. These include side effects, drug interactions and toxic effects due to overdosing. Some patients may also be very sensitive to the normal pharmacological effect of a drug or have a genetic or enzyme deficiency affecting the metabolism of certain drugs....

Chapter 31 - Primary Immune Deficiencies

Jan 04, 2021 | Chemical Pathology

Primary immune deficiencies (PIDs) are inherited, non-communicable disorders that involve a defect in one or more components of the immune system. Primary immune deficiencies are caused by a genetic defect, whereas secondary immune deficiencies occur when the immune system is compromised due to an environmental factor....

Chapter 32 - Vaccination Against Infectious Diseases

Jan 03, 2021 | Chemical Pathology

Vaccination or immunisation may be defined as the artificial production of specific, active immunity to a microorganism by the administration of antigenic material from that organism to an individual. Although often used interchangeably, the term ‘vaccination’ more correctly refers to the administration of those antigens and all that entails, whereas ‘immunisation’ includes the processes by which a person develops immunity. As the latter is a process not routinely tested in everyday practice and includes passive induction of immunity by administration of pre-formed antibodies, in this chapter the term ‘vaccination’ will be used....

Chapter 33 - Snake, Spider, And Scorpion Bites

Jan 02, 2021 | Chemical Pathology

For assistance, please contact the Tygerberg Hospital Poison Information Centre on the 24-hour emergency number: 0861 55777. Anti-venoms are produced by the South African Vaccine Producers. They can be contacted on telephone number 011-386 6000. For further information please refer to their website at http:// www.savp.co.za/....

Index

Jan 01, 2021 | Chemical Pathology

Feel free to use the following index....