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8. Viral diseases
Other measures
– Antibiotic therapy or prophylaxis
• A 7 -d ay co urse o f antibio tics is ind icated fo r infected wo und s (red ness, o ed em a,
p urulent o r sero sang uino us d rainag e, lo calised cellulitis, ly m p h ang itis,
ly m p had eno p athy , fever). A lo nger treatm ent and / o r the p arenteral ro ute m ay be
ind icated in severe infectio n.
• A ntibio tic p ro p hy laxis (5 to 7 d ay s) is reco m m end ed fo r d eep p uncture wo und s,
w o und s o n th e face o r h and s, wo und s invo lving jo ints, tend o ns, ligam ents o r
fractures; very co ntam inated wo und s o r tho se requiring d ebrid em ent; in im m une-
co m p ro m ised p atients.
• A ntibio tic p ro p h y laxis is no t reco m m end ed fo r sup erficial wo und s o r wo und s
m o re th an 2 4 - 4 8 h o urs o ld in p atients sh o w ing no lo cal o r general signs o f
infectio n.
• The sam e d o sage is used fo r bo th treatm ent and p ro p hy laxis:
amoxicillin/ clavulanic acid (co-amoxiclav) P O5 (d o sage exp ressed in am o xicillin):
- C hild ren < 4 0 k g: 4 5 to 5 0 m g/ k g/ d ay in 2 d ivid ed d o ses (if using ratio 8 :1
or
7 :1 ) o r in 3 d ivid ed d o ses (if using ratio 4 :1 )
The d o se o f clavulanic acid sho uld no t exceed 1 2 .5 m g/ k g/ d ay o r 3 7 5
m g/ d ay .
- C hild ren ≥ 4 0 k g and ad ults: 1 5 0 0 to 2 0 0 0 m g/ d ay d ep end ing o n the
fo rm ulatio n
available:
R atio 8 :1 : 2 0 0 0 m g/ d ay = 2 tablets o f 5 0 0 / 6 2 .5 m g 2 tim es p er d ay
R atio 7 :1 : 1 7 5 0 m g/ d ay = 1 tablet o f 8 7 5 / 1 2 5 m g 2 tim es p er d ay
R atio 4 :1 : 1 5 0 0 m g/ d ay = 1 tablet o f 5 0 0 / 1 2 5 m g 3 tim es p er d ay
The d o se o f clavulanic acid sho uld no t exceed 3 7 5 m g/ d ay .
– Tetanus vaccination and immune globulin
V erify vaccinatio n status. If unk no wn o r no t up -to -d ate, see p age 1 7 0 .
8
Co-amoxiclav is the antibiotic of choice. Doxycycline (200 mg/day in 2 divided doses) may be used in penicillin-
5
allergic patients, except in pregnant women and children < 8 years.
Other measures
– Antibiotic therapy or prophylaxis
• A 7 -d ay co urse o f antibio tics is ind icated fo r infected wo und s (red ness, o ed em a,
p urulent o r sero sang uino us d rainag e, lo calised cellulitis, ly m p h ang itis,
ly m p had eno p athy , fever). A lo nger treatm ent and / o r the p arenteral ro ute m ay be
ind icated in severe infectio n.
• A ntibio tic p ro p hy laxis (5 to 7 d ay s) is reco m m end ed fo r d eep p uncture wo und s,
w o und s o n th e face o r h and s, wo und s invo lving jo ints, tend o ns, ligam ents o r
fractures; very co ntam inated wo und s o r tho se requiring d ebrid em ent; in im m une-
co m p ro m ised p atients.
• A ntibio tic p ro p h y laxis is no t reco m m end ed fo r sup erficial wo und s o r wo und s
m o re th an 2 4 - 4 8 h o urs o ld in p atients sh o w ing no lo cal o r general signs o f
infectio n.
• The sam e d o sage is used fo r bo th treatm ent and p ro p hy laxis:
amoxicillin/ clavulanic acid (co-amoxiclav) P O5 (d o sage exp ressed in am o xicillin):
- C hild ren < 4 0 k g: 4 5 to 5 0 m g/ k g/ d ay in 2 d ivid ed d o ses (if using ratio 8 :1
or
7 :1 ) o r in 3 d ivid ed d o ses (if using ratio 4 :1 )
The d o se o f clavulanic acid sho uld no t exceed 1 2 .5 m g/ k g/ d ay o r 3 7 5
m g/ d ay .
- C hild ren ≥ 4 0 k g and ad ults: 1 5 0 0 to 2 0 0 0 m g/ d ay d ep end ing o n the
fo rm ulatio n
available:
R atio 8 :1 : 2 0 0 0 m g/ d ay = 2 tablets o f 5 0 0 / 6 2 .5 m g 2 tim es p er d ay
R atio 7 :1 : 1 7 5 0 m g/ d ay = 1 tablet o f 8 7 5 / 1 2 5 m g 2 tim es p er d ay
R atio 4 :1 : 1 5 0 0 m g/ d ay = 1 tablet o f 5 0 0 / 1 2 5 m g 3 tim es p er d ay
The d o se o f clavulanic acid sho uld no t exceed 3 7 5 m g/ d ay .
– Tetanus vaccination and immune globulin
V erify vaccinatio n status. If unk no wn o r no t up -to -d ate, see p age 1 7 0 .
8
Co-amoxiclav is the antibiotic of choice. Doxycycline (200 mg/day in 2 divided doses) may be used in penicillin-
5
allergic patients, except in pregnant women and children < 8 years.
