Page 271 - Learnwell EVS
P. 271
9. Genito-urinary diseases
– Antibiotic th erapy in ad ults
• Pyelonephritis with no signs of serious illness
ciprofloxacin P O : 1 to 1.5 g /d ay in 2 or 3 d iv id ed d oses for 7 d ays
or cefixime P O : 400 m g /d ay in 2 d iv id ed d oses for 10 d ays
• Presence of signs of serious illness (v om iting , patient seen late in d isease, sepsis) or
patient is in poor general condition (e.g . m alnutrition, presence of oth er d iseases)
ceftriaxone IM : 1 g /once d aily for at least 3 d ays, th en ch ang e to oral treatm ent with
cefixime P O : 400 m g /d ay in 2 d iv id ed d oses to com plete 10 to 14 d ays of treatm ent
(up to 21 d ays d epend ing on clinical response)
+ gentamicin IM : 3 to 6 m g /kg once d aily for 3 d ays (if sepsis)
or, if not av ailable:
ampicillin IV : 8 g /d ay in 3 injections for at least 3 d ays + gentamicin IM : 3 to 6 m g /kg
once d aily for 3 d ays, th en ch ang e to oral treatm ent with amoxicillin P O : 4 g /d ay in
2 d iv id ed d oses to com plete 10 to 14 d ays of treatm ent
– T reatm ent of fev er and pain (use paracetam ol rath er th an N S AID, see pag e 26).
– M aintain proper h yd ration (1.5 litre/d ay in ad ults), especially in ch ild ren (risk of
d eh yd ration); treat d eh yd ration if present (see pag e 315 to 321).
– M anag em ent of septic sh ock if need ed .
9
227
– Antibiotic th erapy in ad ults
• Pyelonephritis with no signs of serious illness
ciprofloxacin P O : 1 to 1.5 g /d ay in 2 or 3 d iv id ed d oses for 7 d ays
or cefixime P O : 400 m g /d ay in 2 d iv id ed d oses for 10 d ays
• Presence of signs of serious illness (v om iting , patient seen late in d isease, sepsis) or
patient is in poor general condition (e.g . m alnutrition, presence of oth er d iseases)
ceftriaxone IM : 1 g /once d aily for at least 3 d ays, th en ch ang e to oral treatm ent with
cefixime P O : 400 m g /d ay in 2 d iv id ed d oses to com plete 10 to 14 d ays of treatm ent
(up to 21 d ays d epend ing on clinical response)
+ gentamicin IM : 3 to 6 m g /kg once d aily for 3 d ays (if sepsis)
or, if not av ailable:
ampicillin IV : 8 g /d ay in 3 injections for at least 3 d ays + gentamicin IM : 3 to 6 m g /kg
once d aily for 3 d ays, th en ch ang e to oral treatm ent with amoxicillin P O : 4 g /d ay in
2 d iv id ed d oses to com plete 10 to 14 d ays of treatm ent
– T reatm ent of fev er and pain (use paracetam ol rath er th an N S AID, see pag e 26).
– M aintain proper h yd ration (1.5 litre/d ay in ad ults), especially in ch ild ren (risk of
d eh yd ration); treat d eh yd ration if present (see pag e 315 to 321).
– M anag em ent of septic sh ock if need ed .
9
227
