Topics in Antibiotic 14

• Principles of antimicrobial use
• Getting to know your drugs
• Antimicrobial hypersensitivity (allergy)
• Bone and joint infections
• Cardiovascular system infections
• Central nervous system infections
• Eye infections
• Genital and sexually transmitted infections
• Human immunodeficiency virus (HIV) infection
• Intra-abdominal infections
• Malaria
• Mycobacterial infections
• Prophylaxis: medical
• Prophylaxis: surgical
• Respiratory tract infections: pneumonia
• Respiratory tract infections: other
• Severe sepsis (sepsis syndrome)
• Skin and soft tissue infections
• Systemic infections
• Urinary tract infections
• Biological warfare agents
• Desensitisation protocols
• Monitoring antimicrobial blood concentrations and aminoglycoside and vancomycin dosing
• Pneumonia severity scoring systems for community-acquired pneumonia in adults
• Pregnancy and breastfeeding
• Renal impairment and antimicrobial dosing

Principles of antimicrobial use

• Antimicrobial resistance
• Prophylactic, empirical or directed antimicrobial therapy
• Route of administration
• Home-based intravenous antimicrobial therapy
• Adverse effects of antimicrobials
• Antimicrobial drug interactions
• Antimicrobial stewardship
• Patient education

Getting to know your drugs

• Antibacterial drugs
• Antifungal drugs
• Antiviral drugs
• Antiprotozoal drugs
• Anthelmintic drugs

Antimicrobial hypersensitivity (allergy)

• Types of hypersensitivity
• Diagnosis of antimicrobial hypersensitivity
• Cross-reactivity between beta lactams
• Management of patients reporting penicillin hypersensitivity

Bone and joint infections

• Osteomyelitis
• Osteomyelitis involving bone and joint prostheses
• Septic arthritis
• Septic bursitis
• Viral arthritis
• Compound (open) fractures

Cardiovascular system infections

• Endocarditis
• Infected aneurysms and intravascular prostheses

Central nervous system infections

• Meningitis
• Brain abscess or subdural empyema
• Epidural abscess
• Neurocysticercosis
• Herpes simplex encephalitis
• Toxoplasma encephalitis

Eye infections

• Blepharitis
• Cellulitis
• Dacryocystitis
• Epiphora
• Meibomian abscess (internal hordeolum) and chalazions
• Stye (external hordeolum)
• Conjunctivitis
• Chlamydia trachomatis conjunctivitis or trachoma
• Gonococcal conjunctivitis
• Gonococcal ophthalmia in neonates
• Corneal abrasion
• Keratitis
• Herpetic retinitis (including cytomegalovirus retinitis)
• Ophthalmic herpes zoster
• Endophthalmitis and penetrating eye injuries

Genital and sexually transmitted infections

• Balanitis
• Epididymo-orchitis
• Chancroid (Haemophilus ducreyi)
• Donovanosis (granuloma inguinale) (Klebsiella granulomatis)
• Pelvic inflammatory disease
• Proctitis
  • Lymphogranuloma venereum (Chlamydia trachomatis L1-L3 serovars)
• Syphilis (Treponema pallidum)
• Urethritis and cervicitis
• Bacterial vaginosis
• Group B streptococcus (Streptococcus agalactiae) in pregnant women
• Trichomoniasis (Trichomonas vaginalis)

Human immunodeficiency virus (HIV) infection

• Indications for antiretroviral therapy
• Before starting antiretroviral therapy
• Antiretroviral drugs
• HIV infection in pregnancy
• Monitoring antiretroviral therapy
• Changing antiretroviral therapy
• Antiretroviral interactions
• Opportunistic infections

Intra-abdominal infections

• Acute cholecystitis
• Ascending cholangitis
• Acute peritonitis
  • Peritonitis due to perforated viscus
  • Spontaneous bacterial peritonitis (SBP)
  • Peritonitis complicating continuous ambulatory peritoneal dialysis
• Acute pancreatitis
• Pyogenic liver abscess

Malaria

• Treatment
• Prophylaxis
• Stand-by emergency treatment

Mycobacterial infections

• Tuberculosis
• Nontuberculous mycobacteria

Prophylaxis: medical

• Prevention of recurrent rheumatic fever
• Prevention of endocarditis
• Prevention of infection in joint prostheses
• Chemoprophylaxis for meningitis
• Prophylaxis for splenectomy and hyposplenic patients
• Prophylaxis for cirrhotic patients with gastrointestinal bleeding
• Prevention of spontaneous bacterial peritonitis
• Post-sexual assault prophylaxis
• Occupational postexposure prophylaxis (PEP) against blood-borne viruses

Prophylaxis: surgical

• General principles
• Abdominal surgery
• Burns, extensive skin loss
• Cardiac surgery
• Head, neck and thoracic surgery
• Lower limb amputation
• Neurosurgery
• Obstetric and gynaecological surgery
• Orthopaedic surgery
• Urological surgery
• Vascular surgery

Respiratory tract infections: pneumonia

• Community-acquired pneumonia in adults
  • Patient assessment
  • Empirical treatment
• Community-acquired pneumonia in children
• Aspiration pneumonia
• Lung abscess
• Hospital-acquired pneumonia
  • Low risk of multidrug-resistant organisms
  • High risk of multidrug-resistant organisms
• Directed antibiotic therapy for specific pneumonias in adults and children
  • Pneumococcal pneumonia
  • Staphylococcal pneumonia
  • Legionella pneumonia
  • Pneumonia due to other pathogens
• Pneumonia in the immunocompromised patient
  • Pneumocystis jiroveci (carinii) pneumonia
  • Bacterial pneumonia in HIV infection
  • Fungal pneumonia

Respiratory tract infections: other

• Influenza
• Pharyngitis and/or tonsillitis
• Acute epiglottitis (supraglottitis)
• Otitis externa
• Otitis media
• Pertussis

Severe sepsis (sepsis syndrome)

• Initial management
• Empirical antimicrobial therapy (no obvious source of infection)
  • Febrile neutropenia
• Empirical antimicrobial therapy (source of infection apparent)
• Directed antimicrobial therapy

Skin and soft tissue infections

• Bites and clenched fist injuries
• Cellulitis and erysipelas
• Cervical lymphadenitis
• Diabetic foot infections
• Mastitis
• Necrotising skin and soft tissue infections
• Superficial thrombophlebitis
• Venous (varicose) ulcers
• Water-related infections
• Wound infections
• Herpes zoster (shingles)

Systemic infections

• Australian spotted fevers and scrub typhus
• Brucellosis
• Cat-scratch disease and other Bartonella infections
• Hydatid disease
• Leptospirosis
• Lyme disease
• Melioidosis
• Q fever
• Schistosomiasis (bilharziasis)
• Typhoid and paratyphoid fevers (enteric fevers)
• Cytomegalovirus (CMV) infections
• Neonatal herpes infection
• Varicella (chicken pox)

Urinary tract infections

• Adults
• Children
• Asymptomatic bacteriuria
• Catheter-associated bacteriuria and urinary tract infections
• Candiduria
• Prostatitis

Biological warfare agents

Desensitisation protocols

• Penicillin protocol
• Sulfonamide protocol

Monitoring antimicrobial blood concentrations and aminoglycoside and vancomycin dosing

• Aminoglycosides
• Beta lactams
• Flucytosine
• Triazole antifungals
• Teicoplanin
• Vancomycin

Pneumonia severity scoring systems for community-acquired pneumonia in adults

• CORB
• SMART-COP

Pregnancy and breastfeeding

Renal impairment and antimicrobial dosing

Publication dates for Antibiotic guidelines

First published 1978
Second edition 1979
Reprinted 1980
Third edition 1982
Reprinted 1983, 1984
Fourth edition 1984
Fifth edition 1987
Reprinted 1988
Sixth edition 1990
Reprinted 1991
Seventh edition 1992
Reprinted 1993
Eight edition 1994
Reprinted 1995
Ninth edition 1996
Tenth edition 1998
Version 11 2000
Version 12 2003
Reprinted 2005
Version 13 2006
Reprinted 2008
Version 14 2010

Suggested citation

Electronic version

Therapeutic Guidelines: Antibiotic is available in electronic format as part of eTG complete for desktop computers and miniTG for handheld devices.