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Remember to check allergy status

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Adult Treatment - Meningitis

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]

Medicine Calendar

Flucloxacillin

500mg QDS

10-14 days

Penicillin allergy: erythromycin OR clarithromycin

erythromycin 250-500mg QDS or clarithromycin 500mg BD

10-14 days

Suspected meningococcal disease

PHE Meningo

Transfer 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.

Medicine Calendar

IV or IM benzylpenicillin

1.2g

Stat dose; give IM if vein cannot be accessed

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]

Medicine Calendar

First line (mild): analgesia

Phenoxymethylpenicillin

500mg QDS

10 days

Penicillin allergy: clarithromycin

250-500mg BD

5 days

The POCAST project is funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London and by the Imperial College Healthcare Charity (Grant Ref No:7006/P36U).