ANTIBIOTIC GUIDELINE CONTENTS Chapter 1: Principles of Diagnosis of Infectious Diseases and Antimicrobial Therapy ..8 Need for representative specimen collection before starting therapy ............................... 8 Initial empirical choice ............................................................................................................... 8 Subsequent need to adjust antimicrobial therapy in light of the laboratory results ........... 8 Monitoring Therapeutic response ............................................................................................. 9 Assays for drugs with narrow Therapeutic:toxic ratio .............................................................. 9 Pharmacokinetic properties of antibiotics ............................................................................... 9 Chapter 2: Notes on Selected Antibiotics ........................................................................11 Beta-Lactams ............................................................................................................................ 11 Penicillins .................................................................................................................................... 11 Cephalosporins ......................................................................................................................... 12 Carbapenems ........................................................................................................................... 14 Aminoglycosides ....................................................................................................................... 14 Quinolones ................................................................................................................................. 15 Tetracyclines .............................................................................................................................. 16 Macrolides ................................................................................................................................. 17 Clindamycin .............................................................................................................................. 17 Chloramphenicol ......................................................................................................................17 Glycopeptides ........................................................................................................................... 17 Cotrimoxazole (Trimethoprim + Sulphamethoxazole) .......................................................... 18 Fusidic acid ................................................................................................................................ 18 Metronidazole ........................................................................................................................... 18 Nitrofurantoin ............................................................................................................................. 18 Rifampicin .................................................................................................................................. 19 Annexure A ................................................................................................................................ 19 Aminoglycosides ....................................................................................................................... 19 Vancomycin .............................................................................................................................. 20 Chapter 3: Generic/Trade Name Lists ..............................................................................21 Chapter 4: Trade/Generic Name Lists ..............................................................................28 Chapter 5: Antibiotics in Pregnancy .................................................................................35 Chapter 6: Antibiotic Prophylaxis In Surgery ....................................................................36 Fundamental principles of Surgical Prophylaxis ....................................................................36 For which type of operations? .................................................................................................36 Timing of antibiotic prophylaxis ...............................................................................................37 Route of administration of prophylactic antibiotics ............................................................. 37 Antibiotic prophylaxis for common surgical operations ....................................................... 37 ...............................................................................................................................................42 Chapter 7: Antibiotic Prophylaxis for Nonsurgical Conditions .......................................43 Bacterial endocarditis .............................................................................................................. 43 Prophylactic regimens .............................................................................................................. 44 Contacts of invasive Haemophilus influenza type b and meningococcal infections ..... 45 Influenza A ................................................................................................................................. 46 Pertussis exposure ......................................................................................................................46 Post-splenectomy ......................................................................................................................46 Rheumatic fever ........................................................................................................................46 Chapter 8: Bone and Joint Infections ...............................................................................47 Osteomyelitis ..............................................................................................................................47 Septic arthritis .............................................................................................................................48 Prosthetic joint infection ...........................................................................................................48 Septic bursitis .............................................................................................................................49 Chapter 9: Cardiovascular Infections ..............................................................................50 Infective endocarditis ...............................................................................................................50 Intravascular catheter-related infection ................................................................................52 Chapter 10: Central Nervous System Infections ..............................................................53 Acute Bacterial Meningitis .......................................................................................................53 Brain abscess .............................................................................................................................55 Chapter 11: Ear, Nose and Throat Infections ...................................................................57 Otitis media ................................................................................................................................57 Mastoiditis ................................................................................................................................... 58 Otitis externa ..............................................................................................................................58 Malignant otitis ..........................................................................................................................58 Sinusitis ........................................................................................................................................58 Pharyngitis/Tonsillitis ...................................................................................................................58 Oral thrush (Candidiasis) ..........................................................................................................59 Chapter 12: Eye Infections .................................................................................................60 Blepharitis ................................................................................................................................... 60 Hordeola .................................................................................................................................... 60 Conjunctivitis ..............................................................................................................................61 Lacrimal system infections .......................................................................................................61 Keratitis (Infection of the cornea) ...........................................................................................62 Chapter 13: Gastrointestinal Infections ............................................................................64 Helicobacter pylori-associated peptic ulceration/gastritis ..................................................64 Infectious Diarrhoea .................................................................................................................64