Drug Prescribing For Dentistry

Transcription

1 September 2014 Update Supplement to the November 2013 Update The following update lists amendments to 2nd Edition (published in August 2011), as a result of changes published in the British National Formulary (BNF) and BNF for Children (BNFC) and is provided in addition to the November 2013 update. The section numbers, section names and pages of the SDCEP guidance that are affected are provided together with the relevant amendments. It can be stored in the pocket at the rear of your copy of the guidance booklet to ensure you have easy access to the most up-to-date advice. Alternatively, the amended drug regimen boxes can be pasted into the booklet at the relevant section. Please note that in the August 2014 update there were minor errors in the following locations: 4.3 & 4.4 The number of amoxicillin capsules to be prescribed for adults. 5.1 & 5.2 The last line of the footnote of the prescribing boxes. The correct information is provided in this September 2014 update which supersedes the August 2014 update. This update and the November 2013 update are available on the SDCEP website: Recent Changes to Antibiotic Prescribing The recommended child doses of amoxicillin were doubled in BNF 68 and BNFC in order to align with common prescribing practices within the UK. This has been reflected in the following updates to amoxicillin drug regimen boxes. 1

2 September 2014 Update Section 4 Bacterial Infections 4.2 Dental Abscess Page 27: the following replaces the drug regimen box for amoxicillin (updated doses for children). An appropriate 5-day regimen is: Amoxicillin Capsules, 500 mg Send: 15 capsules Label: 1 capsule three Amoxicillin Capsules, 250 mg, or Oral Suspension*, 125 mg/5 ml or 250 mg/5 ml 6 months 1 year 125 mg three 1 5 years 250 mg three 5 12 years 500 mg three years 500 mg three NB: The dose of amoxicillin should be doubled in severe infection in adults and children aged years. In severe infection in children aged 6 months to 12 years, the dose of amoxicillin should be increased up to 30 mg/kg (max 1 g) three. Amoxicillin, like other penicillins, can result in hypersensitivity reactions, including rashes and anaphylaxis, and can cause diarrhoea. Do not prescribe amoxicillin to patients with a history of anaphylaxis, urticaria or rash immediately after penicillin administration as these individuals are at risk of immediate hypersensitivity. Updated September 2014, in line with BNF 68 and BNFC changes to amoxicillin doses for children. 2

3 September 2014 Update 4.3 Acute Necrotising Ulcerative Gingivitis and Pericoronitis Page 32: the following replaces the drug regimen box for amoxicillin (updated doses for children). An appropriate 3-day regimen is: Amoxicillin Capsules, 500 mg Send: 9 capsules Label: 1 capsule three Amoxicillin Capsules, 250 mg, or Oral Suspension*, 125 mg/5 ml or 250 mg/5 ml 6 months 1 year 125 mg three 1 5 years 250 mg three 5 12 years 500 mg three years 500 mg three NB: The dose of amoxicillin should be doubled in severe infection in adults and children aged years. In severe infection in children aged 6 months to 12 years, the dose of amoxicillin should be increased up to 30 mg/kg (max 1 g) three. Amoxicillin, like other penicillins, can result in hypersensitivity reactions, including rashes and anaphylaxis, and can cause diarrhoea. Do not prescribe amoxicillin to patients with a history of anaphylaxis, urticaria or rash immediately after penicillin administration as these individuals are at risk of immediate hypersensitivity. Updated September 2014, in line with BNF 68 and BNFC changes to amoxicillin doses for children. 3

4 August 2014 Update September 2014 Update 4.4 Sinusitis Page 33: the following replaces the drug regimen box for amoxicillin (updated doses for children). An appropriate 7-day regimen is: Amoxicillin Capsules, 500 mg Send: 21 capsules Label: 1 capsule three Amoxicillin Capsules, 250 mg, or Oral Suspension*, 125 mg/5 ml or 250 mg/5 ml 6 months 1 year 125 mg three 1 5 years 250 mg three 5 12 years 500 mg three years 500 mg three NB: The dose of amoxicillin should be doubled in severe infection in adults and children aged years. In severe infection in children aged 6 months to 12 years, the dose of amoxicillin should be increased up to 30 mg/kg (max 1 g) three. Amoxicillin, like other penicillins, can result in hypersensitivity reactions, including rashes and anaphylaxis, and can cause diarrhoea. Do not prescribe amoxicillin to patients with a history of anaphylaxis, urticaria or rash immediately after penicillin administration as these individuals are at risk of immediate hypersensitivity. Updated September 2014, in line with BNF 68 and BNFC changes to amoxicillin doses for children. 4

5 August 2014 Update September 2014 Update Section 5 Fungal Infections 5.1 Pseudomembranous Candidosis and Erythematous Candidosis Page 36: the following replaces the drug regimen box for miconazole oromucosal gel (update to treatment duration). If drug treatment is required, an appropriate 7-day regimen is: Send: 80 g tube Label: Apply a pea-sized amount after food four 2 6 years Apply a pea-sized amount twice daily after food 6 18 years Apply a pea-sized amount four after food NB: Advise patient to continue use for 7 days after lesions have healed. Do not prescribe miconazole for patients taking warfarin or statins. Updated September 2014, in line with BNF 68 and BNFC Denture Stomatitis Page 38: the following replaces the drug regimen box for miconazole oromucosal gel (update to treatment duration). If drug treatment is required, an appropriate 7-day regimen is: Send: 80 g tube Label: Apply a pea-sized amount to fitting surface of upper denture after food four 2 6 years Apply a pea-sized amount to fitting surface of upper denture twice daily after food 6 18 years As for adults NB: Advise patient to remove upper denture, apply gel sparingly to fitting surface and then reinsert. Advise patient to continue use for 7 days after lesions have healed. Do not prescribe miconazole for patients taking warfarin or statins. Updated September 2014, in line with BNF 68 and BNFC

6 August 2014 Update September 2014 Update Scottish Dental Clinical Effectiveness Programme Update published September 2014 Scottish Dental Clinical Effectiveness Programme Dundee Dental Education Centre, Frankland Building, Small s Wynd, Dundee DD1 4HN scottishdental.cep@nes.scot.nhs.uk Tel / Website 6