A1258690015mykNl

1
Empirical selection of an antibiotic in
non-outbreak Vibrio cholerae infections in Nepal
at the sub-health and health posts
Patient Entry
Available ATBs TMP-SMX Tetracycline Chloramphenico
l Benzyl Penicillin
Sub-health health posts
Questions Is patient a child, an adult or a
pregnant woman?
If available at the post, Erythromycin
Adult
Child
Pregnant Woman
TMP-SMX
Tetracycline or TMP-SMP or Chloramphenicol
TMP-SMP or Tetracycline if pregnancy ? 3
months
Action Threshold Severity of dehydration
Alert threshold V. cholereae Resistance
Prevalence TMP-SMX ?20 Chloramphenicol
?20 Tetracycline ?10
Child
Pregnant Woman
Adult
Doxycline or Ciprofloxacin (both contraindicated
in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL
INFECTIONS
2
Empirical selection of an antibiotic in
non-outbreak Vibrio cholerae infections in Nepal
at the district level
Patient Entry
Available ATBs Amoxicillin ,TMP-SMX,
Tetracycline, Chloramphenicol, Benzyl
Penicillin, Cloxacillin, Erythromycin,
Ciprofloxacin, Gentamicin, Metronidazole,
Rifampicin, Streptomycin, Ethambutol, Sulfaacetami
de, Doxycycline, Nitrofurantoin
District Level
Questions Is patient a child, an adult or a
pregnant woman?
Erythromycin
Adult
Child
Pregnant Woman
TMP-SMX
Tetracycline or TMP-SMP or Chloramphenicol
TMP-SMP or Tetracycline if pregnancy ? 3
months
Action Threshold Severity of dehydration
Alert threshold V. cholereae Resistance
Prevalence TMP-SMX ?20 Chloramphenicol
?20 Tetracycline ?10
Child
Pregnant Woman
Adult
Doxycline or Ciprofloxacin (both contraindicated
in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL
INFECTIONS
3
Empirical selection of an antibiotic in
non-outbreak Vibrio cholerae infections in Nepal
at the national level
Patient Entry
Available ATBs Amoxicillin ,TMP-SMX,
Tetracycline, Chloramphenicol, Benzyl
Penicillin, Cloxacillin, Erythromycin,
Ciprofloxacin, Gentamicin, Metronidazole,
Rifampicin, Streptomycin, Ethambutol, Sulfaacetami
de, Doxycycline, Nitrofurantoin, Cefotaxime
National Level
Questions Is patient a child, an adult or a
pregnant woman?
Erythromycin
Adult
Child
Pregnant Woman
TMP-SMX
Tetracycline or TMP-SMP or Chloramphenicol
TMP-SMP or Tetracycline if pregnancy ? 3
months
Action Threshold Severity of dehydration
Alert threshold V. cholereae Resistance
Prevalence TMP-SMX ?20 Chloramphenicol
?20 Tetracycline ?10
Child
Pregnant Woman
Adult
Doxycline or Ciprofloxacin (both contraindicated
in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL
INFECTIONS
4
Empirical selection of an antibiotic in
non-outbreak N. gonorrheae infections in Nepal at
the sub-health and health posts
Patient Entry
Available ATBs TMP-SMX Tetracycline Chloramphenico
l Benzyl Penicillin
Sub-health health posts
Questions Is patient a child, an adult or a
pregnant woman?
If available at the post, Azithromycin
Adult
Child
Pregnant Woman
Benzyl Penicillin
Benzyl Penicillin
Benzyl Penicillin
Action Threshold Disease Specific
Alert threshold N. gonorrheae Resistance
Prevalence PPNG ? 5
Child
Pregnant Woman
Adult
Ceftriaxone ( IM) or Cefixime (PO) Norfloxacin,
Ciprofloxacin and Ofloxacin WHO PRESCRIBING GUIDE
FOR BACTERIAL INFECTIONS
5
Empirical selection of an antibiotic in
non-outbreak N. gonorrheae infections in Nepal at
the district level
Patient Entry
Available ATBs Amoxicillin ,TMP-SMX,
Tetracycline, Chloramphenicol, Benzyl
Penicillin, Cloxacillin, Erythromycin,
Ciprofloxacin, Gentamicin, Metronidazole,
Rifampicin, Streptomycin, Ethambutol, Sulfaacetami
de, Doxycycline, Nitrofurantoin
District Level
Questions Is patient a child, an adult or a
pregnant woman?
If available at the post, Azithromycin
Adult
Child
Pregnant Woman
Benzyl Penicillin TMP-SMX
Tetracycline, TMP-SMX or Chloramphenicol
TMP-SMX or Tetracycline if pregnancy ? 3
months
Action Threshold Disease Specific
Alert threshold N. gonorrheae Resistance
Prevalence PPNG ? 5
Child
Pregnant Woman
Adult
Ceftriaxone ( IM) or Cefixime (PO) norfloxacin,
ciprofloxacin and ofloxacin WHO PRESCRIBING GUIDE
FOR BACTERIAL INFECTIONS
6
Empirical selection of an antibiotic in
non-outbreak N. gonorrheae infections in Nepal at
the national level
Patient Entry
Available ATBs Amoxicillin ,TMP-SMX,
Tetracycline, Chloramphenicol, Benzyl
Penicillin, Cloxacillin, Erythromycin,
Ciprofloxacin, Gentamicin, Metronidazole,
Rifampicin, Streptomycin, Ethambutol, Sulfaacetami
de, Doxycycline, Nitrofurantoin, Cefotaxime
National Level
Questions Is patient a child, an adult or a
pregnant woman?
If available at the post, Azithromycin
Adult
Child
Pregnant Woman
TMP-SMX
Tetracycline or TMP-SMP or Chloramphenicol
TMP-SMP or Tetracycline if pregnancy ? 3
months
Action Threshold Disease Specific
Alert threshold N. gonorrheae Resistance
Prevalence PPNG ? 5
Child
Pregnant Woman
Adult
Ceftriaxone ( IM) or Cefixime (PO) norfloxacin,
ciprofloxacin and ofloxacin WHO PRESCRIBING GUIDE
FOR BACTERIAL INFECTIONS
7
Empirical selection of an antibiotic in
non-outbreak Shigella sp. infections in Nepal at
the sub-health and health posts
Patient Entry
Available ATBs TMP-SMX Tetracycline Chloramphenico
l Benzyl Penicillin
Sub-health health posts
Questions Is patient a child, an adult or a
pregnant woman?
If available at the post, Erythromycin
Adult
Child
Pregnant Woman
TMP-SMX
Tetracycline or TMP-SMP or Chloramphenicol
TMP-SMP or Tetracycline if pregnancy ? 3
months
Action Threshold Severity of dehydration
Alert threshold Shigella sp. Resistance
Prevalence TMP-SMX ?20 Chloramphenicol
?20 Tetracycline ?10
Child
Pregnant Woman
Adult
Doxycline or Ciprofloxacin (both contraindicated
in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL
INFECTIONS
8
Empirical selection of an antibiotic in
non-outbreak Shigella sp. infections in Nepal at
the district level
Patient Entry
Available ATBs Amoxicillin ,TMP-SMX,
Tetracycline, Chloramphenicol, Benzyl
Penicillin, Cloxacillin, Erythromycin,
Ciprofloxacin, Gentamicin, Metronidazole,
Rifampicin, Streptomycin, Ethambutol, Sulfaacetami
de, Doxycycline, Nitrofurantoin
District Level
Questions Is patient a child, an adult or a
pregnant woman?
If available at the post, Erythromycin
Adult
Child
Pregnant Woman
TMP-SMX
Tetracycline or TMP-SMP or Chloramphenicol
TMP-SMP or Tetracycline if pregnancy ? 3
months
Action Threshold Severity of dehydration
Alert threshold Shigella sp. Resistance
Prevalence TMP-SMX ?20 Chloramphenicol
?20 Tetracycline ?10
Child
Pregnant Woman
Adult
Doxycline or Ciprofloxacin (both contraindicated
in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL
INFECTIONS
9
Empirical selection of an antibiotic in
non-outbreak Shigella sp. infections in Nepal at
the national level
Patient Entry
Available ATBs Amoxicillin ,TMP-SMX,
Tetracycline, Chloramphenicol, Benzyl
Penicillin, Cloxacillin, Erythromycin,
Ciprofloxacin, Gentamicin, Metronidazole,
Rifampicin, Streptomycin, Ethambutol, Sulfaacetami
de, Doxycycline, Nitrofurantoin, Cefotaxime
National Level
Questions Is patient a child, an adult or a
pregnant woman?
If available at the post, Erythromycin
Adult
Child
Pregnant Woman
TMP-SMX
Tetracycline or TMP-SMP or Chloramphenicol
TMP-SMP or Tetracycline if pregnancy ? 3
months
Action Threshold Severity of dehydration
Alert threshold Shigella sp. Resistance
Prevalence TMP-SMX ?20 Chloramphenicol
?20 Tetracycline ?10
Child
Pregnant Woman
Adult
Doxycline or Ciprofloxacin (both contraindicated
in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL
INFECTIONS