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National Treatment Guidelines for Antimicrobial Use in Infectious Diseases

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National Treatment Guidelines for Antimicrobial Use in Infectious Diseases National Treatment Guidelines for Antimicrobial Use in Infectious Diseases Version 1.0 (2016) NATIONAL CENTRE FOR DISEASE CONTROL Directorate General of Health Services Ministry of Health & Family Welfare Government of India CONTENTS Chapter 1 .................................................................................................................................................................................................................. 7 Introduction ........................................................................................................................................................................................................ 7 Chapter 2. ................................................................................................................................................................................................................. 9 Syndromic Approach For Empirical Therapy Of Common Infections.......................................................................................................... 9 A. Gastrointestinal & Intra-Abdominal Infections ......................................................................................................................................... 10 B. Central Nervous System Infections ........................................................................................................................................................... 13 C. Cardiovascular Infections .......................................................................................................................................................................... 14 D. Skin & Soft Tissue Infections ................................................................................................................................................................... 15 E. Respiratory Tract Infections ...................................................................................................................................................................... 16 F. Urinary Tract Infections ............................................................................................................................................................................. 17 G. Obstetrics And Gynaecological Infections ................................................................................................................................................ 18 H. Bones And Joint Infections ....................................................................................................................................................................... 22 I. Eye Infections ............................................................................................................................................................................................ 23 J. Ear Infections ............................................................................................................................................................................................ 25 K. Infections in Burn and Plastic Surgery ...................................................................................................................................................... 26 L. Fungal Infections ...................................................................................................................................................................................... 27 M. Febrile Neutropenia .................................................................................................................................................................................. 27 N. Post-Cardiovascular Surgery Infections .................................................................................................................................................... 29 O. Pediatric Infections ................................................................................................................................................................................... 31 P. Neonatal Infections .................................................................................................................................................................................... 39 R. Post Solid Organ Transplant ...................................................................................................................................................................... 40 S. Surgical Antimicrobial Prophylaxis ........................................................................................................................................................... 41 Chapter 3 ................................................................................................................................................................................................................ 42 Treatment Of Muti-Drug Resistant Bacterial Pathogens .............................................................................................................................. 42 1. Methicillin- Resistant S. aureus (MRSA) .................................................................................................................................................. 42 2. Vancomycin Resistant Enterococcus (VRE) ........................................................................................................................................... 42 3. Extended Spectrum Βeta-Lactamases (ESBL) Producing Enterobacteriaceae. .......................................................................................... 42 4. Carbapenem- Resistant Enterobacteriaceae (CRE) .................................................................................................................................... 42 Chapter 4 ................................................................................................................................................................................................................ 44 Guidelines For Optimizing Use Of Key Antimicrobials ................................................................................................................................ 44 A. Antimicrobial Prescribing: Good Practice ................................................................................................................................................ 44 B. Reserve Antimicrobials ............................................................................................................................................................................ 45 C. Hypersensitivity ....................................................................................................................................................................................... 45 D. Alert Antimicrobials.................................................................................................................................................................................. 46 E. Alert Antibiotics And Their Indications .................................................................................................................................................... 46 Chapter 5 ................................................................................................................................................................................................................ 49 Preventive Strategies For Healthcare Associated Infections ......................................................................................................................... 49 A. Healthcare Associated Infections .............................................................................................................................................................. 49 B. Reducing the risk of Health care associated infections.............................................................................................................................. 49 Chapter 6 ................................................................................................................................................................................................................ 50 Monitoring Antimicrobial Use ......................................................................................................................................................................... 50 A. Background ............................................................................................................................................................................................... 50 B. Need For Surveillance To Track Antimicrobial Use And Resistance ....................................................................................................... 50 C. Standardized Methodology And Outcome Measures ................................................................................................................................ 50 D. Situation In Developing Countries ............................................................................................................................................................ 51 High-end Antibiotic Monitoring Sheet .......................................................................................................................................................... 52 Surgical Prophylaxis Monitoring Sheet ......................................................................................................................................................... 52
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