Page 212 - Learnwell EVS
P. 212
7. Bacterial diseases
cefixime P O fo r 7 d ay s m ay be an alternative to cip ro flo xacine in child ren und er
1 5 y ears:
C hild ren o ver 3 m o nths: 1 5 to 2 0 m g/ k g/ d ay in 2 d ivid ed d o ses
F ailing that, and in the absence o f resistance:
amoxicillin P O fo r 1 4 d ay s
C hild ren: 7 5 to 1 0 0 m g/ k g/ d ay in 3 d ivid ed d o ses
A d ults: 3 g/ d ay in 3 d ivid ed d o ses
or
chloramphenicol P O fo r 1 0 to 1 4 d ay s d ep end ing o n severity
C hild ren: 1 0 0 m g/ k g/ d ay in 3 d ivid ed d o ses
A d ults: 3 g/ d ay in 3 d ivid ed d o ses
• S . typhi is rap id ly d evelo p ing resistance to quino lo nes. I n this event, use:
ceftriaxone IM o r I1V fo r 1 0 to 1 4 d ay s d ep end ing o n severity
C hild ren: 7 5 m g/ k g o nce d aily
A d ults: 2 to 4 g o nce d aily
Antibiotic treatment in pregnant or breast-feeding women
In p regnant wo m en, ty p ho id carries a m ajo r risk o f m aternal co m p licatio ns
(intestinal
p erfo ratio n, p erito nitis, sep ticaem ia) and fo etal co m p licatio ns ( m iscarriage,
p rem ature d elivery , intrauterine d eath).
• InamthoexicaibllsinePncOe o:f3regs/isdtaanycein: 3 d ivid ed d o ses fo r 1 4 d ay s
• IfcereftsriiasxtaonnceeI:M o r IV : 2 to 4 g o nce d aily fo r 1 0 to 1 4 d ay s d ep end ing o n severity
1
F ailing that, use ciprofloxacin P O (usually no t reco m m end ed fo r p regnant o r breast-
feed ing wo m en. H o wever, the life-threatening risk o f ty p ho id o utweighs the risk o f
ad verse effects). F o r d o sage, see 7
abo ve.
Note: fever p ersists fo r 4 to 5 d ay s after the start o f treatm ent, even if the antibio tic is
effective. It is essential to treat th e fever and to check fo r p o ssible m aternal o r fo etal
co m p licatio ns.
– IdnexpamaetitehnatssonperIeVse:nltoinagdsienvgedreotsyep3homidg,/wkithg atondxicthceonn1fumsio gn/akl sgtaeteve(rhya6lluchionautrios fnos,r 2 d ay
altered co nscio usness) o r intestinal haem o rrhage:
Prevention
– D isinfectio n o f faeces with 2 % chlo rine so lutio n.
– Ind ivid ual (hand washing) and co llective hy giene (safe water sup p ly , sanitatio n).
– T he p o ssibility o f vaccinatio n m ust be co nsid ered : it can be useful in so m e situatio ns
(high-risk age gro up , hy p erend em ic z o ne), but its effectiveness rem ains co ntro versial.
The solvent of ceftriaxone for IM injection contains lidocaine. Ceftriaxone reconstituted using this solvent must
1
NEVER be administered by IV route. For IV administration, water for injection must always be used.
175
cefixime P O fo r 7 d ay s m ay be an alternative to cip ro flo xacine in child ren und er
1 5 y ears:
C hild ren o ver 3 m o nths: 1 5 to 2 0 m g/ k g/ d ay in 2 d ivid ed d o ses
F ailing that, and in the absence o f resistance:
amoxicillin P O fo r 1 4 d ay s
C hild ren: 7 5 to 1 0 0 m g/ k g/ d ay in 3 d ivid ed d o ses
A d ults: 3 g/ d ay in 3 d ivid ed d o ses
or
chloramphenicol P O fo r 1 0 to 1 4 d ay s d ep end ing o n severity
C hild ren: 1 0 0 m g/ k g/ d ay in 3 d ivid ed d o ses
A d ults: 3 g/ d ay in 3 d ivid ed d o ses
• S . typhi is rap id ly d evelo p ing resistance to quino lo nes. I n this event, use:
ceftriaxone IM o r I1V fo r 1 0 to 1 4 d ay s d ep end ing o n severity
C hild ren: 7 5 m g/ k g o nce d aily
A d ults: 2 to 4 g o nce d aily
Antibiotic treatment in pregnant or breast-feeding women
In p regnant wo m en, ty p ho id carries a m ajo r risk o f m aternal co m p licatio ns
(intestinal
p erfo ratio n, p erito nitis, sep ticaem ia) and fo etal co m p licatio ns ( m iscarriage,
p rem ature d elivery , intrauterine d eath).
• InamthoexicaibllsinePncOe o:f3regs/isdtaanycein: 3 d ivid ed d o ses fo r 1 4 d ay s
• IfcereftsriiasxtaonnceeI:M o r IV : 2 to 4 g o nce d aily fo r 1 0 to 1 4 d ay s d ep end ing o n severity
1
F ailing that, use ciprofloxacin P O (usually no t reco m m end ed fo r p regnant o r breast-
feed ing wo m en. H o wever, the life-threatening risk o f ty p ho id o utweighs the risk o f
ad verse effects). F o r d o sage, see 7
abo ve.
Note: fever p ersists fo r 4 to 5 d ay s after the start o f treatm ent, even if the antibio tic is
effective. It is essential to treat th e fever and to check fo r p o ssible m aternal o r fo etal
co m p licatio ns.
– IdnexpamaetitehnatssonperIeVse:nltoinagdsienvgedreotsyep3homidg,/wkithg atondxicthceonn1fumsio gn/akl sgtaeteve(rhya6lluchionautrios fnos,r 2 d ay
altered co nscio usness) o r intestinal haem o rrhage:
Prevention
– D isinfectio n o f faeces with 2 % chlo rine so lutio n.
– Ind ivid ual (hand washing) and co llective hy giene (safe water sup p ly , sanitatio n).
– T he p o ssibility o f vaccinatio n m ust be co nsid ered : it can be useful in so m e situatio ns
(high-risk age gro up , hy p erend em ic z o ne), but its effectiveness rem ains co ntro versial.
The solvent of ceftriaxone for IM injection contains lidocaine. Ceftriaxone reconstituted using this solvent must
1
NEVER be administered by IV route. For IV administration, water for injection must always be used.
175
