Use for prophylaxis

Question 1

Rheumatic fever: prevention of recurrence

Answer 1

Phenoxymethylpenicillin or sulfadiazin

Question 2

Invasive group A streptococcal infection: prevention of secondary cases

Answer 2

1) Phenoxymethylpenicillin

2) penicillin allergic: Either erythromycin or azithromycin

Question 3

Meningococcal meningitis: prevention of secondary cases

Answer 3

Ciprofloxacin or rifampicinor i/m ceftriaxone

Question 4

Haemophilus influenzae type b disease: prevention of secondary cases

Answer 4

Rifampicin

Question 5

Diphtheria in non-immune patients: prevention of secondary cases

Answer 5

Erythromycin

Question 6

Pneumococcal infection in asplenia or in patients with sickle-cell disease, antibacterial prophylaxis

Answer 6

Phenoxymethylpenicillin.

Question 7

Pertussis, antibacterial prophylaxis

Answer 7

Clarithromycin

Question 8

Animal and human bites, antibacterial prophylaxis

Answer 8

1) Co-amoxiclav alone (or doxycycline + metronidazole if penicillin-allergic)
2) Antibacterial prophylaxis recommended for wounds less than 48–72 hours old when the risk of infection is high. Give prophylaxis for up to 5 days
3) Cleanse wound thoroughly. For tetanus-prone wound, give human tetanus immunoglobulin
4) Consider rabies prophylaxis for bites from animals in endemic countries.

Question 9

when should antibacterial prophylaxis be given for surgical procedures?

Answer 9

Intravenous antibacterial prophylaxis should be given up to 30 minutes before the procedure.

Question 10

Open fractures

Answer 10

Use i/v co-amoxiclav alone or i/v cefuroxime

Question 11

Termination of pregnancy

Answer 11

Single dose of oral metronidazole

Question 12

NICE guidance: Antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures

Answer 12

1) Chlorhexidine mouthwash is not recommended for the prevention of infective endocarditis in at risk patients
2) Antibacterial prophylaxis is not routinely recommended