Remember to check allergy status
Prevention of secondary case of meningitis: Only prescribe following advice from Public Health Doctor: 9 am – 5 pm
Out of hours: Contact on-call doctor
Mastitis
S. aureus is the most common infecting pathogen.[1D] Suspect if woman has: a painful breast;[2D] fever and/or general malaise;[2D] a tender, red breast.[2D]
Breastfeeding: oral antibiotics are appropriate, where indicated.[2D,3A+] Women should continue feeding,[1D,2D] including from the affected breast.[2D]
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Flucloxacillin |
500mg QDS |
10-14 days |
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Penicillin allergy: erythromycin OR clarithromycin |
erythromycin 250-500mg QDS or clarithromycin 500mg BD |
10-14 days |
Suspected meningococcal disease
PHE MeningoTransfer all patients to hospital immediately.
If clinician has time before hospital admission, and non-blanching rash, give IV benzylpenicillin or IV cefotaxime. 1-3 B+ Do not give IV antibiotics if there is a definite history of anaphylaxis; rash is not a contraindication. 1 B-. Give IM if vein cannot be accessed.
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IV or IM benzylpenicillin |
1.2g |
Stat dose; give IM if vein cannot be accessed |
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or IV or IM cefotaxime |
1g |
Stat dose; give IM if vein cannot be accessed |
Scarlet fever (GAS)
Prompt treatment with appropriate antibiotics significantly reduces the risk of complications.[1D] Observe immunocompromised individuals (diabetes; women in the puerperal period; chickenpox) as they are at increased risk of developing invasive infection.[1D]
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First line (mild): analgesia |
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Phenoxymethylpenicillin |
500mg QDS |
10 days |
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Penicillin allergy: clarithromycin |
250-500mg BD |
5 days |
