Chemoprophylaxis Flashcards
What is the definition of chemoprophylaxis?
The use of an antimicrobial drug to PREVENT infection
What are some of the cons of chemoprophylaxis?
- cost
- adverse effects (drug interactions, side effects)
- disturbance of the normal human flora
- selection of antibiotic resistance
When would you use prophylaxis against group B strep infections?
group B strep is part of the normal vaginal flora
but can cause neonatal meningitis and septicaemia (passing through birth canal)
higher-risk for pre-term babies
Action: antibiotic prophylaxis (penicillin - cross placenta) can be given to mum in labour if:
- pre-term labour
- prolonged rupture of membranes (amniotic sac)
- past history
mums not routinely screened for group b strep in UK
Why would you give prophylaxis for rheumatic fever?
rheumatic fever = immunological response to infection with s.pyogenes
repeated attacks can cause valvular damage.
now rare but commonly occurred in children.
After 1 documented attack, children can be put on penicillin prophylaxis until 16 (to prevent recurrence, and risk of endocarditis)
What would you give as prophylaxis for close “kissing” contacts of meningitis patients?
close contacts = Ciprofloxacin, Rifampicin
can’t if pregnant: IM injection of Ceftriaxone
What are the national guidelines for prophylaxis in splenectomised patients?
important to keep up with immunisations
offer penicillin prophylaxis to prevent pneumococcal infections
What prophylaxis would you give a HIV patient?
when CD4 drops, can be vulnerable to AIDS
if a patient develops pneumocystic pneumonia (PCP) is a strong indicator that CD4 count is dropping
= give Co-trimoxazole
For which surgery types would you administer antibiotic prophylaxis?
- clean with implant - can get infection on implant, e.g. valve replacement, hip replacement
- contaminated - colorectal surgery
- dirty - REQUIRES FULL ANTIBIOTIC COURSE!
