Prescribers, trained nurses and pharmacist

Size: px
Start display at page:

Download "Prescribers, trained nurses and pharmacist"

Transcription

1 Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Author: Contact Name and Job Title Directorate & Speciality Guideline for the Management of Infections in Eyes, Ears, Nose and Throat in adults Sarah Partridge, Antimicrobial Pharmacist Mr Marshall Consultant ENT Mr John Sharp Opthalmology SpR Fiona Donald, Consultant Microbiologist Diagnostics and Clinical Support, Microbiology Date of submission December 2015 Explicit definition of patient group to which it applies (e.g. Adult patients with named infections inclusion and exclusion criteria, diagnosis) Version 1.0 If this version supersedes another clinical guideline please be explicit about which guideline it replaces including version number. Changes from previous guideline Statement of the evidence base of the guideline has the guideline been peer reviewed by colleagues? Evidence base: (1-5) 1a meta analysis of randomised controlled trials 1b at least one randomised controlled trial 2a at least one well-designed controlled study without randomisation 2b at least one other type of well-designed quasiexperimental study 3 well designed non-experimental descriptive studies (ie comparative / correlation and case studies) 4 expert committee reports or opinions and / or clinical experiences of respected authorities 5 recommended best practise based on the clinical experience of the guideline developer Consultation Process Ratified by: Date: Target audience Review date: December 2018 Majority of information previously published in the document entitled Summary of Antibiotic Recommendations, which has now been discontinued. Not applicable. Local microbiological sensitivity surveillance Recommended best practice based on clinical experience of guideline developers SIGN guideline (2010). Management of sore throat and indications for tonsillectomy. Available online from: (accessed ) Public Health England (2014) Management of infection guidance for primary care for consultation and adaption. Available online from: (accessed ) NUH Antimicrobial Guidelines Committee, NUH Drugs and Therapeutics Committee, ENT and opthalmology NUH Antimicrobial Guidelines Committee 2 nd September 2015 Prescribers, trained nurses and pharmacist This guideline has been registered with the trust. However, clinical guidelines are guidelines only. The interpretation and application of clinical guidelines will remain the responsibility of the individual clinician. If in doubt contact a senior colleague or expert. Caution is advised when using guidelines after the review date. Page 1 of 15

2 GUIDELINE FOR THE MANAGEMENT OF INFECTIONS IN EYES, EARS, NOSE AND THROAT IN ADULTS Contents Page 1. Introduction 3 2. Eye Infections Acute Bacterial Conjunctivitis Chlamydial Conjunctivitis 2.3 Orbital Cellulitis 2.4 Herpes Zoster Ophthalmicus 2.5 Endophthalmitis 2.6 Corneal infection (keratitis) 3. Ear, Nose & Throat (ENT) Infections 3.1 Upper Respiratory Tract Infection 3.2 Acute Tonsillitis / Sore Throat 3.3 Quinsy or Peri-tonsillar Abscess 3.4 Acute Epiglottitis 3.5 Acute Otitis Media 3.5 Mastoiditis 3.7 Otitis Externa 3.8 Malignant / necrotising otitis externa 3.9 Acute Bacterial Sinusitis 3.10 Ludwig s angina 3.11 Para-pharyngeal / Retro-pharyngeal abscess 3.12 Parotitis Page 2 of 15

3 Guideline for the Management of Infections in Eyes, Ears, Nose and Throat 1. Introduction This guideline recommends empiric antimicrobial treatment options for adult patients with specified eye, ear, nose and throat infections. 2. Eye Infections 2.1 Acute Bacterial Conjunctivitis Common causative pathogens: Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae Viral conjunctivitis may be associated with upper respiratory tract symptoms and is usually self-limiting. General approach: Infective conjunctivitis is a self-limiting illness and for most people settles without treatment. Watch and wait for 3-4 days. If treatment is required see below. If contact lenses are usually worn these should be removed until all symptoms and signs of infection have completely resolved and any treatment has been completed for 24 hours. The possibility of a serious corneal infection must be considered in any contact lens user with a red, painful eye (see below).contact lens wearers and those patients who have had previous intraocular surgery e.g. glaucoma drainage, refer to opthamology/contact eye casualty. Symptomatic and empirical treatment is usually adequate. Chloramphenicol 0.5% eye drops 1 drop to affected eye(s) 2 hourly reducing to QDS as the infection improves. Continue for 48 hours after resolution, usually 5-7 days. If not responding to treatment, or if severe, refer to ophthalmology. 2.2 Chlamydial Conjunctivitis These should be considered in patients with risk factors for sexually transmitted diseases or in cases of chronic conjunctivitis. Clean off any exudate and swab the conjunctiva with a chlamydia swab and a bacterial swab. Page 3 of 15

4 Doxycycline PO 100mg BD for 7 days. If patient is pregnant use Erythromycin PO 500mg QDS for 7 days. Alternative: Azithromycin PO 1g single dose (see advice below regarding using Azithromycin in pregnancy). Where compliance with Erythromycin is likely to be a problem the patient can be offered Azithromycin PO 1g as a single dose following a discussion around the potential risks and benefits of its use with the patient. If gonococcus is suspected, seek advice on treatment from GUM and ophthalmology. Contact tracing and follow-up to be arranged through GUM when diagnosis confirmed. 2.3 Orbital Cellulitis Pre-septal cellulitis refers to infections localised to the lids. These are commonly caused by infected cysts, wounds or from sinuses. The septum provides some barrier to spread of infection into the orbit. In contrast, orbital cellulitis is infection in the orbit, often due to spread of infection from the sinuses through the thin lamina papyracea into the orbit. Symptoms of sinusitis or upper respiratory infection therefore often precede orbital cellulitis. It is a potentially sight and life-threatening infection due to spread to the cavernous sinus. Management is usually by ENT and ophthalmology. Care under a medical team may be required for patients who are unwell. Early discussion with ITU should be performed if there are signs of systemic deterioration. Diabetic or immunosuppressed patients may develop serious fungal infections, and necrotizing fasciitis should also always be considered. Common causative pathogens: Staphylococcus aureus, Streptococci (including the Streptococcus milleri group), Anaerobes, Haemophilus influenza. Blood cultures. Swabs if any pus or exudate. If intracranial extension suspected, please contact Microbiology for advice. Co-amoxiclav IV 1.2g TDS. Converting to Co-amoxiclav PO 625mg TDS for a total of 10 days. Page 4 of 15

5 Mild penicillin allergy: Cefuroxime IV 1.5g TDS plus Metronidazole IV 500mg TDS. Converting to Cefalexin PO 500mg TDS plus Metronidazole PO 400mg TDS for a total of 10 days. Severe penicillin allergy (e.g. anaphylaxis, angioedema, urticarial rash in first 72 hours) or cephalosporin allergy: Ciprofloxacin IV 400mg BD plus Metronidazole IV 500mg TDS plus Vancomycin IV (refer to antibiotic website for dosing, pre-dose level monitoring advice and the Vancomycin dosing calculator). Converting to Levofloxacin PO 500mg OD plus Metronidazole PO 400mg TDS for a total of 10 days. 2.4 Herpes Zoster Ophthalmicus Potentially sight- threatening reactivation of the varicella zoster virus within the trigeminal ganglion affecting the ophthalmic division of the nerve. Ocular involvement occurs in more than fifty percent of cases with the potential for serious complications. Aciclovir PO 800mg 5 times a day for 7 days. Refer patient to ophthalmology for ocular examination. 2.5 Endophthalmitis This usually presents with a history of intraocular surgery or intravitreal injection. Rapid replication of pathogens over hours, as in sepsis, causes potentially permanent loss of vision. Contact ophthalmology immediately. Emergency administration of intravitreal Amikacin 0.4mg/0.1ml and intravitreal Vancomycin 1mg/0.1ml by ophthalmologist. Vitreous tap performed at same procedure for microscopy, culture and sensitivity. Oral antibiotics may be given according to preference of consultant ophthalmologist. Page 5 of 15

6 2.6 Corneal Infection (Keratitis) Commonly related to contact lens use, but also associated with numerous other causes. Always serious and sight threatening. Urgently refer cases to ophthalmology for corneal scrape for microscopy, culture and sensitivity and initiation of topical antibiotics STEROID-CONTAINING EYE DROPS SHOULD NEVER BE INITIATED UNLESS UNDER THE DIRECTION OF AN OPHTHALMOLOGIST. Ear, Nose and Throat (ENT) Infections 3.1 Upper Respiratory Tract Infection If clinical presentation suggests a viral infection, antibiotics are not indicated. Send a viral throat swab or naso-pharyngeal aspirate if influenza suspected or patient is immunocompromised (see current influenza guidelines and Microbiology A Z guide.) 3.2 Acute Tonsillitis / Sore Throat The majority of sore throats are viral but there is clinical overlap between viral and streptococcal infections. The most common bacterial pathogen is Streptococcus pyogenes (Group A streptococcus). Group C and G streptococci may also be found in throat swabs but their role is less clear. Consider Diphtheria in patients who have recent foreign travel eg to Russia, South Asia, Africa. Contact Duty Medical Microbiologist or Infectious Diseases (ID) consultant immediately if you suspect diphtheria. Antibiotics are more likely to be helpful in patients with: a history of otitis media general clinical condition of concern Group A haemolytic streptococcus isolated in an inpatient infection control reasons for example during an outbreak Using the Centor score, score 1 for each of the following. If scores more than 3 consider treatment. Fever Tonsillar exudate Tender cervical lymphadenopathy Absence of cough Page 6 of 15

7 Throat swab in bacterial transport medium. If treatment is required: Penicillin V PO 500mg QDS for 10 days. If unable to swallow use Benzylpenicillin IV 1.2g QDS converting to Penicillin V PO 500mg QDS. Total duration IV and PO is 10 days. If penicillin allergic: Clarithromycin PO 500mg BD for 5 days (or IV if unable to swallow). 3.3 Quinsy or Peri-tonsillar Abscess Symptoms can include a worsening sore throat, usually on one side, pyrexia, difficulty opening the mouth, pain on or difficulty swallowing, swelling around face and neck, earache on the affected side, changes to voice or difficulty swallowing. Primarily caused by Streptococcus pyogenes. (Group A streptococcus). Send swab or pus only if recurrent or complicated infection or the patient is immune compromised. Appropriate surgical and airway management. Benzylpenicillin IV 1.2g QDS plus Metronidazole IV 500mg TDS. Converting to Penicillin V PO 500mg QDS and Metronidazole PO 400mg TDS Total course length (IV and PO) is 7-10 days. Mild penicillin allergy: Cefuroxime IV 1.5g TDS and Metronidazole IV 500mg TDS. Converting to Cefalexin PO 500mg TDS and Metronidazole PO 400mg TDS Total course length (IV and PO) is 7-10 days. Penicillin anaphylaxis / severe allergy or allergy to cephalosporins: Clindamycin IV 600mg QDS (until patient is able to swallow capsules). Converting to Clindamycin PO 450mg QDS. Total course length (IV and PO) 7-10 days. Note if Group A streptococcus cultured then Metronidazole does not need to be continued. 3.4 Acute Epiglottitis Page 7 of 15

8 Common causative pathogens Haemophilus influenzae type b, Diphtheria, Streptococcus pyogenes Respiratory obstruction due to diphtheria is rare but has a characteristic false membrane and swelling can extend from the pharynx to involve the uvula. Please contact duty Medical Microbiologist or Infectious Diseases if you suspect diphtheria. Investigations: Take blood cultures. Take a throat swab ONCE THE AIRWAY IS SECURE, otherwise respiratory obstruction may be precipitated. Ensure sample is labelled as being from the epiglottis. Protect the airway. Ceftriaxone IV 2g OD Note treatment should be reviewed with culture and sensitivity results. If clinically well and able to swallow switch to: Co-amoxiclav PO 625mg TDS OR if penicillin allergy: Levofloxacin PO 500mg OD Total course length (PO and IV) should be 7 days. Severe penicillin allergy (e.g. anaphylaxis, angioedema, urticarial rash in first 72 hours) or cephalosporin allergy: Vancomycin IV (refer to antibiotic website for dosing, pre-dose level monitoring advice and the Vancomycin dosing calculator) plus Ciprofloxacin IV 400mg BD If clinically well and able to swallow switch to: Levofloxacin PO 500mg OD Total course length (PO and IV) should be 7 days. 3.5 Acute Otitis Media Common causative pathogens Many are viral. Common bacterial causes: Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis. Please refer patients who are not settling, who are immunocompromised or have complications to ENT for review. Bacterial swab may be useful if pus is present. Page 8 of 15

9 Treatment (if antibiotics indicated): Illness resolves over 4 days in 80% without antibiotics. Antibiotics do not reduce pain in the first 24 hours, subsequent attacks or deafness. If indicated use: Amoxicillin PO 500mg TDS for 5 days or if failure to respond to amoxicillin, Co-amoxiclav PO 625mg TDS for 5 days. Penicillin allergy: Clarithromycin PO 500mg BD for 5 days. 3.6 Mastoiditis This is an infection of the mastoid bone and air cells, normally confirmed by CT or MRI scan. It can be a severe complication of otitis media. Rarely the infection can spread and cause meningitis or cerebral abscess. All patients with suspected mastoiditis should be referred to ENT for review. Discuss antibiotic treatment with microbiology. Where surgical drainage is required, pus samples should be sent for culture ideally from the post-auricular abscess or mastoid cavity. Assess for neurological signs including meningitis or altered conscious levels. Take blood cultures. Co-amoxiclav IV 1.2g TDS. Converted to Co-amoxiclav PO 625mg TDS. Prolonged antibiotic courses of 2-4 weeks may be required. Mild penicillin allergy: Cefuroxime IV 1.5g TDS and Metronidazole IV 500mg TDS. Converting to Cefalexin PO 500mg TDS and Metronidazole PO 400mg TDS. Prolonged antibiotic courses of 2-4 weeks may be required. Severe penicillin allergy (e.g. anaphylaxis, angioedema, urticarial rash in first 72 hours) or cephalosporin allergy: Ciprofloxacin IV 400mg BD plus Metronidazole IV 500mg TDS plus Vancomycin IV (refer to antibiotic website for dosing, pre-dose level monitoring advice and the Vancomycin dosing calculator). Converting to Levofloxacin PO 500mg OD plus Metronidazole PO 400mg TDS. Prolonged antibiotic courses of 2-4 weeks may be required. Note treatment should be reviewed with culture and sensitivity results. Page 9 of 15

10 3.7 Otitis Externa It is important to exclude an underlying chronic otitis media. Common causative pathogens Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Aspergillus spp. In exceptional cases, swab for culture and sensitivity. Local aural toilet with or without topical antibiotic is the treatment of choice (for firstline options available see table 1). Table 1: First-line Topical Treatment Options for Otitis Externa Preparation Normal Dose Recommended duration Acetic Acid 2% (Earcalm Spray ) Dexamethasone with Antibacterial (Sofradex ) Hydrocortisone Acetate 1% with Gentamicin 0.3% (Gentisone HC) Dexamethasone with Antibacterial (Otomize ) Flumetasone 0.02% with Clioquinol 1% (Locorten-Vioform ) Ciprofloxacin drops 0.3% (Ciloxin ) 1 spray at least TDS (maximum 2-3 hourly) 2-3 drops TDS- QDS 2-4 drops TDS- QDS Comments 7 days Is as effective as topical antibiotics in mild otitis externa. 7 days 7 days 1 spray TDS 7 days 2-3 drops BD 7 days 2-3 drops TDS- QDS 7 days EAR drops not available, but EYE drops are acceptable to use in the ear Systemic antibiotics are only indicated when there is evidence of spreading cellulitis. Diabetic and immunocompromised patients are susceptible to malignant otitis externa, and aggressive destruction of cartilage. Refer urgently to an ENT specialist. Page 10 of 15

11 3.8 Malignant / necrotising otitis externa This requires admission, an ENT work up including imaging of the temporal bone, and prolonged IV antibiotics (usually at least 6 weeks) usually based on Microbiology advice. Ensure all patients are referred to ENT for review. Send pus and deep tissue samples for culture. Initial empirical treatment Piperacillin / Tazobactam IV 4.5g TDS and Ciprofloxacin PO 750mg BD (Use IV route if oral route not available e.g. nil by mouth, swallowing difficulties, absorption issues). If allergic to penicillin: Discuss with microbiology Treatment should be reviewed and discussed with microbiology. 3.9 Acute Bacterial Sinusitis Common causative pathogens Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus Diagnosis can be difficult please refer all patients to ENT for review. Many cases are viral and usually resolve within 2 3 weeks. Antibiotics are indicated in severe symptoms or those with symptoms for >10 days. Nose swabs / swabs of mucous are not helpful. Endoscopy directed cultures may be helpful in complicated cases, refer to ENT. If antibiotics indicated: Amoxicillin PO 500mg TDS for 7 days. Penicillin allergy: Doxycycline PO 100mg BD for 1 day, then 100mg OD for 6 days or Clarithromycin PO 500mg BD for 7 days Ludwig s angina Ludwig's Angina is a rapidly progressive cellulitis of the submandibular spaces, with potential for significant upper airway obstruction. Most reported cases follow an odontogenic infection. Common causative pathogens Usually polymicrobial involving mouth organisms such as streptococci, anaerobes, actinomyces. Blood cultures. If drainage of abscess, send pus to microbiology. Page 11 of 15

12 Refer all patients to ENT. Ensure safe airway management. If abscesses are present they should be drained. Discuss antibiotic treatment with microbiology / ENT Para-pharyngeal / Retro-pharyngeal abscess Parapharyngeal space infections are potentially life-threatening because of the possibility of involving the carotid sheath and its contents (e.g. common carotid artery, internal jugular vein, vagus nerve), propensity for airway impingement, and bacteraemic dissemination. Since the clinical presentation may be dominated by the symptoms and signs of the primary source of infection, the diagnosis of parapharyngeal space involvement is often delayed. Infection of the parapharyngeal space may arise from different sources throughout the neck. Dental infections are the most common underlying cause, followed by peritonsillar abscess, and rarely parotitis, otitis, or mastoiditis (Bezold's abscess). Refer urgently to specialist ENT. Common causative pathogens Usually polymicrobial involving mouth or upper respiratory tract bacteria including streptococci, anaerobes, actinomyces. Treatment (if antibiotics are indicated): Appropriate surgical and airway management. Discuss with Microbiology / ENT. Prolonged course of IV antibiotics may be required depending on progress. Send PUS sample to microbiology and discuss treatment if not improving. Co-amoxiclav IV 1.2g TDS. Converting to Co-amoxiclav PO 625mg TDS. Mild Penicillin allergy: Cefuroxime IV 1.5g TDS plus Metronidazole IV 500mg TDS. Converting to Cefalexin PO 500mg TDS plus Metronidazole PO 400mg TDS. Severe penicillin allergy (e.g. anaphylaxis, angioedema, urticarial rash in first 72 hours) or cephalosporin allergy: Discuss with microbiology Parotitis Normally characterised by unilateral swelling of the parotid gland with potential abscess formation. Acute infection of the parotid gland can be caused by a variety of bacteria and viruses. Acute suppurative parotitis often occurs in the setting of debilitation, dehydration, and poor oral hygiene, particularly among elderly patients. Common causative organisms Page 12 of 15

13 Staphylococcus aureus (most common cause), Streptococcus pyogenes. Duct pus swab for culture if present. Blood cultures if systemically unwell. Treatment (if antibiotics are indicated): 1 st line (if not at risk of MRSA see below): Flucloxacillin IV 2g QDS with Metronidazole IV 500 mg TDS if anaerobes suspected e.g. poor dentition. Converting to Flucloxacillin PO 500 mg QDS +/- Metronidazole PO 400 mg TDS. Total course length 7 10 days. Penicillin allergy: Clindamycin IV 600mg QDS converting to oral 450 mg QDS when able to swallow. Total course length 7 10 days. If patient known to be or previously MRSA positive, use: Vancomycin IV (refer to antibiotic website for dosing, pre-dose level monitoring advice and the Vancomycin dosing calculator) plus Metronidazole IV 500mg TDS For oral switch, consult with microbiology. Page 13 of 15

14 Equality Impact Assessment Report 1. Name of Policy or Service Response to external best practice policy 2. Responsible Manager Tim Hills Lead pharmacist antimicrobials and Infection control 3. Name of person Completing EIA Annette Clarkson 4. Date EIA Completed 10/12/ Description and Aims of Policy/Service Guideline for the Management of Infections in Eyes, Ears, Nose and Throat 6. Brief Summary of Research and Relevant Data There is no research or relevant data at the present time. 7. Methods and Outcome of Consultation Consultations have been carried out with the following: NUH Drugs and Therapeutics Committee NUH Antibiotic Guidelines Committee Comments from the above consultations have been received and incorporated where appropriate Page 14 of 15

15 8. Results of Initial Screening or Full Equality Impact Assessment: Equality Group Age Gender Race Sexual Orientation Religion or belief Disability Dignity and Human Rights Working Patterns Social Deprivation Assessment of Impact 9. Decisions and/or Recommendations (including supporting rationale) From the information contained in the procedure, and following the initial screening, it is my decision that a full assessment is not required at the present time. 10. Equality Action Plan (if required) N/A 11. Monitoring and Review Arrangements Review: December 2018 Page 15 of 15

Antibiotic Guidelines: Ear Nose and Throat (ENT) Infections. Contents

Antibiotic Guidelines: Ear Nose and Throat (ENT) Infections. Contents Antibiotic Guidelines: Ear Nose and Throat (ENT) Infections. Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine

More information

Blue Team Teaching Module: Periorbital/Orbital Infections

Blue Team Teaching Module: Periorbital/Orbital Infections Blue Team Teaching Module: Periorbital/Orbital Infections Format: 1. Case 2. Topic Summary 3. Questions 4. References Case: A 3-year-old boy presents with 2 days of increasing redness, swelling, and pain

More information

Title: Antibiotic Guideline for Acute Pelvic Inflammatory Disease

Title: Antibiotic Guideline for Acute Pelvic Inflammatory Disease Title: Antibiotic Guideline for Acute Pelvic Inflammatory Disease Version 3 Date ratified December 2007 Review date December 2009 Ratified by NUH Antimicrobial Guidelines Committee Gynaecology Directorate

More information

Nursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection

Nursing college, Second stage Microbiology Dr.Nada Khazal K. Hendi L14: Hospital acquired infection, nosocomial infection L14: Hospital acquired infection, nosocomial infection Definition A hospital acquired infection, also called a nosocomial infection, is an infection that first appears between 48 hours and four days after

More information

Childhood ENT disorders. When to refer to specialists. Claire Harris

Childhood ENT disorders. When to refer to specialists. Claire Harris Childhood ENT disorders When to refer to specialists Claire Harris Background. Ear, nose and throat (ENT) are among the commonest reasons for attendance in general practice. Acute problems are managed

More information

SECTION 6 THERAPEUTIC DRUG MONITORING

SECTION 6 THERAPEUTIC DRUG MONITORING SECTION 6 THERAPEUTIC DRUG MONITORING Kieran Hand Consultant Pharmacist Anti-infectives The objectives of this section are: To test your ability to monitor serum levels for drugs with a narrow therapeutic

More information

BE SURE. BE SAFE. VACCINATE.

BE SURE. BE SAFE. VACCINATE. DON T GET OR GIVE THE FLU THIS YEAR THANK YOU Vaccination is the only protection. www.immunisation.ie BE SURE. BE SAFE. VACCINATE. FLU VACCINE 2013-2014 Healthcare workers prevent the spread of flu and

More information

Royal National Throat, Nose and Ear Hospital

Royal National Throat, Nose and Ear Hospital Royal National Throat, Nose and Ear Hospital Sore throats and quinsy Ear, Nose and Throat Surgery 2 Sore throat (pharyngitis) This is very common and normally gets better after a few days and is usually

More information

Recurrent or Persistent Pneumonia

Recurrent or Persistent Pneumonia Recurrent or Persistent Pneumonia Lower Respiratory Tract Dr T Avenant Recurrent or Persistent Pneumonia Definitions Recurrent pneumonia more than two episodes of pneumonia in 18 months Persistent pneumonia

More information

Chapter 10. All chapters, full text, free download, available at http://www.divingmedicine.info SINUS BAROTRAUMA ANATOMY OF THE SINUSES

Chapter 10. All chapters, full text, free download, available at http://www.divingmedicine.info SINUS BAROTRAUMA ANATOMY OF THE SINUSES Chapter 10 All chapters, full text, free download, available at http://www.divingmedicine.info SINUS BAROTRAUMA ANATOMY OF THE SINUSES The sinuses are air filled cavities contained within the bones of

More information

Appropriate Treatment for Children with Upper Respiratory Infection

Appropriate Treatment for Children with Upper Respiratory Infection BCBS ACO Measure Appropriate Treatment for Children with Upper Respiratory Infection HEDIS Measure CPT II coding required: YES Click here to go to Table of Contents BCBS Measure: Page 50 of 234 Dated:

More information

VARICELLA ZOSTER (VZ) VIRUS, CHICKENPOX & SHINGLES GUIDANCE

VARICELLA ZOSTER (VZ) VIRUS, CHICKENPOX & SHINGLES GUIDANCE VARICELLA ZOSTER (VZ) VIRUS, CHICKENPOX & SHINGLES GUIDANCE Summary This guidance provides background information on varicella zoster (VZ), chickenpox and shingles and sets out the infection control measures

More information

PRESEPTAL AND ORBITAL CELLULITIS IN CHILDREN- CLINICAL GUIDELINE 1. Aim/Purpose of this Guideline

PRESEPTAL AND ORBITAL CELLULITIS IN CHILDREN- CLINICAL GUIDELINE 1. Aim/Purpose of this Guideline PRESEPTAL AND ORBITAL CELLULITIS IN CHILDREN- CLINICAL GUIDELINE 1. Aim/Purpose of this Guideline 1.1. This guideline applies to medical and nursing staff caring for a child with Preseptal and Orbital

More information

POAC CLINICAL GUIDELINE

POAC CLINICAL GUIDELINE POAC CLINICAL GUIDELINE Acute Pylonephritis DIAGNOSIS COMPLICATED PYELONEPHRITIS EXCLUSION CRITERIA: Male Known or suspected renal impairment (egfr < 60) Abnormality of renal tract Known or suspected renal

More information

SHINGLES (Herpes zoster infection)

SHINGLES (Herpes zoster infection) SHINGLES (Herpes zoster infection) What are the aims of this leaflet? This leaflet has been written to help you understand more about shingles. It will tell you what it is, what causes it, what can be

More information

Clinical Reasoning Handout: URI Symptoms Sore Throat. 1) Pearls

Clinical Reasoning Handout: URI Symptoms Sore Throat. 1) Pearls Clinical Reasoning Handout: URI Symptoms Sore Throat 1) Pearls Background: Sore throat is one the most common symptoms evaluated in primary care Almost 5% of patient report sore throat as the primary reason

More information

ANTIBIOTICS IN SEPSIS

ANTIBIOTICS IN SEPSIS ANTIBIOTICS IN SEPSIS Jennifer Curello, PharmD, BCPS Clinical Pharmacist, Infectious Diseases Antimicrobial Stewardship Program Ronald Reagan UCLA Medical Center October 27, 2014 The power of antibiotics

More information

Treatment of Fever and Infection in Children with Transfusion Dependent Thalassaemia

Treatment of Fever and Infection in Children with Transfusion Dependent Thalassaemia Treatment of Fever and Infection in Children with Transfusion Dependent Thalassaemia Document Information Version: 2 Date: June 2014 Authors (incl. job title): Professor David Rees, Sue Height (consultant

More information

APPENDIX I-A: INFORMED CONSENT BB IND 11184 Protocol CDC IRB #4167

APPENDIX I-A: INFORMED CONSENT BB IND 11184 Protocol CDC IRB #4167 APPENDIX I-A: INFORMED CONSENT BB IND 11184 Protocol CDC IRB #4167 INFORMED CONSENT FOR USE OF DIPHTHERIA ANTITOXIN (DAT) FOR SUSPECTED DIPHTHERIA CASES Investigational New Drug (IND) BB 11184 Protocol

More information

Plan early - get your vaccinations in time for full protection. To prepare for your trip, schedule an appointment: (910) 347-2154, option #2.

Plan early - get your vaccinations in time for full protection. To prepare for your trip, schedule an appointment: (910) 347-2154, option #2. The Onslow County Health Department Travel Clinic offers a complete line of immunizations and prescriptions to protect you while traveling abroad. The most appropriate immunizations and travel medications

More information

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY Measure #65 (NQF 0069): Appropriate Treatment for Children with Upper Respiratory Infection (URI) National Quality Strategy Domain: Efficiency and Cost Reduction 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES:

More information

Version 2 This guideline describes how to manage patients who are showing signs and symptoms of alcohol withdrawal and Wernicke s Encephalopathy.

Version 2 This guideline describes how to manage patients who are showing signs and symptoms of alcohol withdrawal and Wernicke s Encephalopathy. Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Contact Name and Job Title (author) Directorate & Speciality A Guideline for the Management of Acute Alcohol Withdrawal

More information

Streptococcal Infections

Streptococcal Infections Streptococcal Infections Introduction Streptococcal, or strep, infections cause a variety of health problems. These infections can cause a mild skin infection or sore throat. But they can also cause severe,

More information

Other Causes of Fever

Other Causes of Fever T e c h n i c a l S e m i n a r s Other Causes of Fever Febrile Illness Causes Fever After Seven Days Referral Relapsing Fever - Borreliosis Overview JHR Adaptation Sore Throat Overview Prevention Management

More information

Measure Name: URI Treatment without Antibiotics for Children Measure Code: URI Lab Data: N

Measure Name: URI Treatment without Antibiotics for Children Measure Code: URI Lab Data: N Measure Name: URI Treatment without Antibiotics for Children Owner: NCQA (URI) Measure Code: URI Lab Data: N Rule Description: General Criteria Summary The percentage of children 3 months -18 years of

More information

X-Plain Sinus Surgery Reference Summary

X-Plain Sinus Surgery Reference Summary X-Plain Sinus Surgery Reference Summary Introduction Sinus surgery is a very common and safe operation. Your doctor may recommend that you have sinus surgery. The decision whether or not to have sinus

More information

The flu vaccination WINTER 2016/17. Who should have it and why. Flu mmunisation 2016/17

The flu vaccination WINTER 2016/17. Who should have it and why. Flu mmunisation 2016/17 The flu vaccination WINTER 2016/17 Who should have it and why Flu mmunisation 2016/17 The flu vaccination 1 Winter 2016/17 Helping to protect everyone, every winter This leaflet explains how you can help

More information

school for boys Persistent streptococcal throat infection in a preparatory BY J. H. D. BRISCOE

school for boys Persistent streptococcal throat infection in a preparatory BY J. H. D. BRISCOE J. Hyg., Camb. (1985), 95, 671-676 671 Printed in Great Britain Persistent streptococcal throat infection in a preparatory school for boys BY J. H. D. BRISCOE Eton Court House, Eton, Windsor, Berkshire

More information

APPENDIX B: UWHC SURGICAL ANTIMICROBIAL PROPHYLAXIS GUIDELINES

APPENDIX B: UWHC SURGICAL ANTIMICROBIAL PROPHYLAXIS GUIDELINES APPENDIX B: UWHC SURGICAL ANTIMICROBIAL PROPHYLAXIS GUIDELINES Principles of prophylaxis 1) Use antimicrobials for surgical procedures where prophylactic antimicrobials have been found to be beneficial.

More information

Nasal and Sinus Disorders

Nasal and Sinus Disorders Nasal and Sinus Disorders Chronic Nasal Congestion When nasal obstruction occurs without other symptoms (such as sneezing, facial pressure, postnasal drip etc.) then a physical obstruction might be the

More information

Swine Flu and Common Infections to Prepare For. Rochester Recreation Club for the Deaf October 15, 2009

Swine Flu and Common Infections to Prepare For. Rochester Recreation Club for the Deaf October 15, 2009 Swine Flu and Common Infections to Prepare For Rochester Recreation Club for the Deaf October 15, 2009 Supporters Deaf Health Community Committee Members Julia Aggas Cathie Armstrong Michael McKee Mistie

More information

C-Difficile Infection Control and Prevention Strategies

C-Difficile Infection Control and Prevention Strategies C-Difficile Infection Control and Prevention Strategies Adrienne Mims, MD MPH VP, Chief Medical Officer Adrienne.Mims@AlliantQuality.org 1/18/2016 1 Disclosure This educational activity does not have commercial

More information

Treatment of sexually transmitted and other genital infections

Treatment of sexually transmitted and other genital infections www.bpac.org.nz keyword: sti Treatment of sexually transmitted and other genital infections Key reviewer: Dr Murray Reid, Sexual Health Physician, Auckland Sexual Health Service General points: If one

More information

Sinusitis is ubiquitous among humans and one of the most common reasons

Sinusitis is ubiquitous among humans and one of the most common reasons Sinusitis Kathleen Fitch, MSN, APRN,BC, FNP Gennine Zinner, RNC, ANP Sinusitis is ubiquitous among humans and one of the most common reasons health care office visits in the USA. In 1991 sinusitis accounted

More information

WARNING LETTER. According to its approved product labeling (PI) (in pertinent part, emphasis original):

WARNING LETTER. According to its approved product labeling (PI) (in pertinent part, emphasis original): DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service Food and Drug Administration Silver Spring, MD 20993-0002 TRANSMITTED BY FACSIMILE Sapan A. Shah, Ph.D. President and Chief Executive Officer

More information

Patient Guide. Important information for patients starting therapy with LEMTRADA (alemtuzumab)

Patient Guide. Important information for patients starting therapy with LEMTRADA (alemtuzumab) Patient Guide Important information for patients starting therapy with LEMTRADA (alemtuzumab) This medicinal product is subject to additional monitoring. This will allow quick identification of new safety

More information

35-40% of GBS disease occurs in the elderly or in adults with chronic medical conditions.

35-40% of GBS disease occurs in the elderly or in adults with chronic medical conditions. What is Group B Strep (GBS)? Group B Streptococcus (GBS) is a type of bacteria that is found in the lower intestine of 10-35% of all healthy adults and in the vagina and/or lower intestine of 10-35% of

More information

Solid Organ Transplantation

Solid Organ Transplantation Solid Organ Transplantation Infection Prevention And Control Transplant Atlantic 2011 October 13/2011 Kathy Hart Introduction In the past several years, the drugs that we use, the surgeries themselves,

More information

FAQs on Influenza A (H1N1-2009) Vaccine

FAQs on Influenza A (H1N1-2009) Vaccine FAQs on Influenza A (H1N1-2009) Vaccine 1) What is Influenza A (H1N1-2009) (swine flu) 1? Influenza A (H1N1-2009), previously known as "swine flu", is a new strain of influenza virus that spreads from

More information

A child with earache. Are antibiotics the best treatment? Chris Del Mar, Paul Glasziou. (Australian Family Physician, vol 31, No 2, feb 2002, 141-144)

A child with earache. Are antibiotics the best treatment? Chris Del Mar, Paul Glasziou. (Australian Family Physician, vol 31, No 2, feb 2002, 141-144) A child with earache Are antibiotics the best treatment? Chris Del Mar, Paul Glasziou (Australian Family Physician, vol 31, No 2, feb 2002, 141-144) Background. Conventional management of acute otitis

More information

Frequently Asked Questions

Frequently Asked Questions Guidelines for Testing and Treatment of Gonorrhea in Ontario, 2013 Frequently Asked Questions Table of Contents Background... 1 Treatment Recommendations... 2 Treatment of Contacts... 4 Administration

More information

COMPOSITION: Each capsule contains clindamycin hydrochloride equivalent to 150 mg clindamycin base.

COMPOSITION: Each capsule contains clindamycin hydrochloride equivalent to 150 mg clindamycin base. APPROVED PACKAGE INSERT DALACIN C 150 mg CAPSULES SCHEDULING STATUS: S4 PROPRIETARY NAME (and dosage form): DALACIN C TM 150 mg (Capsules) COMPOSITION: Each capsule contains clindamycin hydrochloride equivalent

More information

MINISTRY OF HEALTH PANDEMIC INFLUENZA A / H1N1 2009 VACCINE FREQUENTLY ASKED QUESTIONS

MINISTRY OF HEALTH PANDEMIC INFLUENZA A / H1N1 2009 VACCINE FREQUENTLY ASKED QUESTIONS Government of the Republic of Trinidad and Tobago MINISTRY OF HEALTH PANDEMIC INFLUENZA A / H1N1 2009 VACCINE FREQUENTLY ASKED QUESTIONS Influenza vaccines are one of the most effective ways to protect

More information

EAR, NOSE AND THROAT (ENT) ASSESSMENT

EAR, NOSE AND THROAT (ENT) ASSESSMENT This assessment is effective as of October 2014. For more information or to provide feedback on this or any other decision support tool, e-mail certifiedpractice@crnbc.ca EAR, NOSE AND THROAT (ENT) ASSESSMENT

More information

Sore Throat. Definition. Causes. (Pharyngitis; Tonsillopharyngitis; Throat Infection) Pronounced: Fare-en-JY-tis /TAHN-sill-oh-fare-en-JY-tis

Sore Throat. Definition. Causes. (Pharyngitis; Tonsillopharyngitis; Throat Infection) Pronounced: Fare-en-JY-tis /TAHN-sill-oh-fare-en-JY-tis Sore Throat (Pharyngitis; Tonsillopharyngitis; Throat Infection) Pronounced: Fare-en-JY-tis /TAHN-sill-oh-fare-en-JY-tis by Jennifer Lewy, MSW En Español (Spanish Version) Definition A sore throat is the

More information

PNEUMONIA Debra Mercer BSN, RN, RRT

PNEUMONIA Debra Mercer BSN, RN, RRT PNEUMONIA Debra Mercer BSN, RN, RRT 1 Objectives Following this presentation the participant will demonstrate understanding of pneumonia by successful completion of the Pneumonia I.Q. Quiz (7 or more correct

More information

Childhood Diseases and potential risks during pregnancy: (All information available on the March of Dimes Web Site.) http://www.modimes.

Childhood Diseases and potential risks during pregnancy: (All information available on the March of Dimes Web Site.) http://www.modimes. Childhood Diseases and potential risks during pregnancy: (All information available on the March of Dimes Web Site.) http://www.modimes.org/ Fifth disease (erythema infectiosum) is a common, mild, childhood

More information

Sexually Transmitted Infections (STI) One Day Update

Sexually Transmitted Infections (STI) One Day Update Sexually Transmitted Infections (STI) One Day Update February 2015 Overview STI Guideline Changes National STI Services Results Reporting High Transmission Areas: Key Populations STI Guideline Changes

More information

SWINE FLU: FROM CONTAINMENT TO TREATMENT

SWINE FLU: FROM CONTAINMENT TO TREATMENT SWINE FLU: FROM CONTAINMENT TO TREATMENT SWINE FLU: FROM CONTAINMENT TO TREATMENT INTRODUCTION As Swine Flu spreads and more people start to catch it, it makes sense to move from intensive efforts to contain

More information

Title of Guideline. Thrombosis Pharmacist)

Title of Guideline. Thrombosis Pharmacist) Title of Guideline Contact Name and Job Title (author) Guideline for patients receiving Rivaroxaban (Xarelto ) requiring Emergency Surgery or treatment for Haemorrhage Julian Holmes (Haemostasis and Thrombosis

More information

Conjunctivitis - Pink Eye

Conjunctivitis - Pink Eye Conjunctivitis - Pink Eye Introduction Conjunctivitis is often called pink eye. It causes inflammation of the thin, clear lining inside the eyelid and on the white of the eye. The inflammation gives the

More information

EAST CAROLINA UNIVERSITY INFECTION CONTROL POLICY. Methicillin-resistant Staph aureus: Management in the Outpatient Setting

EAST CAROLINA UNIVERSITY INFECTION CONTROL POLICY. Methicillin-resistant Staph aureus: Management in the Outpatient Setting EAST CAROLINA UNIVERSITY INFECTION CONTROL POLICY Methicillin-resistant Staph aureus: Management in the Outpatient Setting Date Originated: Date Reviewed: Date Approved: Page 1 of Approved by: Department

More information

Urinary Tract Infections

Urinary Tract Infections Urinary Tract Infections Overview A urine culture must ALWAYS be interpreted in the context of the urinalysis and patient symptoms. If a patient has no signs of infection on urinalysis, no symptoms of

More information

COMMON BACTERIAL SKIN INFECTIONS IN GENERAL PRACTICE

COMMON BACTERIAL SKIN INFECTIONS IN GENERAL PRACTICE COMMON BACTERIAL SKIN INFECTIONS IN GENERAL PRACTICE The two most common bacteria to cause skin infections are staphylococcus aureus (staph aureus ) and streptococcus pyogenes ( strep) (see Table 1). Staphylococcus

More information

YALE UNIVERSITY SCHOOL OF MEDICINE: SECTION OF OTOLARYNGOLOGY PATIENT INFORMATION FUNCTIONAL ENDOSCOPIC SINUS SURGERY

YALE UNIVERSITY SCHOOL OF MEDICINE: SECTION OF OTOLARYNGOLOGY PATIENT INFORMATION FUNCTIONAL ENDOSCOPIC SINUS SURGERY YALE UNIVERSITY SCHOOL OF MEDICINE: SECTION OF OTOLARYNGOLOGY PATIENT INFORMATION FUNCTIONAL ENDOSCOPIC SINUS SURGERY What is functional endoscopic sinus surgery (FESS)? Functional endoscopic sinus surgery

More information

IMPORTANT: PLEASE READ

IMPORTANT: PLEASE READ PART III: CONSUMER INFORMATION combined hepatitis A (inactivated) and hepatitis B (recombinant) vaccine This leaflet is part III of a three-part "Product Monograph" published when was approved for sale

More information

Cervical lymphadenopathy

Cervical lymphadenopathy Cervical lymphadenopathy Introduction There are various classifications of lymphadenopathy, but a simple and clinically useful system is to classify lymphadenopathy as "generalized" if lymph nodes are

More information

3.0 Treatment of Infection

3.0 Treatment of Infection 3.0 Treatment of Infection Antibiotics and Medicine National Curriculum Link SCN 3-13b SCN 3-20b HWB 3-15a HWB 3-16a HWB 3-17a Learning Outcomes All students will know: Most common infections will get

More information

2 P age. Babies from Birth to Age 2

2 P age. Babies from Birth to Age 2 Contents Babies from Birth to Age 2... 2 Vaccines give parents the power... 2 Vaccines are recommended throughout our lives... 3 Talk to your doctor... 3 Vaccines are very safe... 3 Whooping Cough (Pertussis)...

More information

RECOMMENDATION FOR THE USE OF ANTIBIOTICS FOR THE TREATMENT OF INFECTION

RECOMMENDATION FOR THE USE OF ANTIBIOTICS FOR THE TREATMENT OF INFECTION RECOMMENDATION FOR THE USE OF ANTIBIOTICS FOR THE TREATMENT OF INFECTION Aims to provide a simple, best guess approach to the treatment of common infections, based on known sensitivity and resistance patterns

More information

Protecting your baby against meningitis and septicaemia

Protecting your baby against meningitis and septicaemia Protecting your baby against meningitis and septicaemia caused by meningococcal B bacteria MenB vaccine now available! Information about the MenB vaccine and recommended paracetamol use mmunisation The

More information

Antibiotic-Associated Diarrhea, Clostridium difficile- Associated Diarrhea and Colitis

Antibiotic-Associated Diarrhea, Clostridium difficile- Associated Diarrhea and Colitis Antibiotic-Associated Diarrhea, Clostridium difficile- Associated Diarrhea and Colitis ANTIBIOTIC-ASSOCIATED DIARRHEA Disturbance of the normal colonic microflora Leading to alterations in bacterial degradation

More information

Acute pelvic inflammatory disease: tests and treatment

Acute pelvic inflammatory disease: tests and treatment Acute pelvic inflammatory disease: tests and treatment Information for you Information for you Published August 2010 Published in August 2010 (next review date: 2014) Acute What is pelvic inflammatory

More information

PLAN OF ACTION FOR. Physician Name Signature License Date

PLAN OF ACTION FOR. Physician Name Signature License Date PLAN OF ACTION FOR Patient s copy (patient s name) I Feel Well Lignes I feel short directrices of breath: I cough up sputum daily. No Yes, colour: I cough regularly. No Yes I Feel Worse I have changes

More information

Facts About Chickenpox and Shingles for Adults

Facts About Chickenpox and Shingles for Adults Facts About Chickenpox and Shingles for Adults What is chickenpox? Chickenpox, also known as varicella, is a very contagious disease caused by the varicella-zoster virus. It is spread easily through the

More information

THERAPY OF ANAEROBIC INFECTIONS LUNG ABSCESS BRAIN ABSCESS

THERAPY OF ANAEROBIC INFECTIONS LUNG ABSCESS BRAIN ABSCESS THERAPY OF ANAEROBIC INFECTIONS Douglas Black, Pharm.D. Associate Professor School of Pharmacy University of Washington dblack@u.washington.edu LUNG ABSCESS A lung abscess is a localized pus cavity in

More information

41 Viral rashes and skin infections

41 Viral rashes and skin infections 41 Viral rashes and skin infections Clinical There are several kinds of skin infections caused by viruses, and these are best considered in the four categories that group together similar symptoms for

More information

Dr Hoi Ping Mok/Infectious Diseases Guidelines/28.12.11 Review < 28.12.16

Dr Hoi Ping Mok/Infectious Diseases Guidelines/28.12.11 Review < 28.12.16 Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Contact Name and Job Title (author) Directorate & Speciality Guideline for the management of skin and soft tissue

More information

Wound Care on the Field. Objectives

Wound Care on the Field. Objectives Wound Care on the Field Brittany Witte, PT, DPT Cook Children s Medical Center Objectives Name 3 different types of wounds commonly seen in sports and how to emergently provide care for them. Name all

More information

Holy Family University, Student Health Services, Directions for Completion of Health Packet

Holy Family University, Student Health Services, Directions for Completion of Health Packet 1 Holy Family University, Student Health Services, Directions for Completion of Health Packet All forms are to be returned to Health Services by Summer Orientation for the Fall Semester and the first day

More information

PERIOCULAR (SUBTENON) STEROID INJECTION ERIC S. MANN M.D.,Ph.D.

PERIOCULAR (SUBTENON) STEROID INJECTION ERIC S. MANN M.D.,Ph.D. PERIOCULAR (SUBTENON) STEROID INJECTION ERIC S. MANN M.D.,Ph.D. A. INDICATIONS: Periocular steroid injection involves placement of steroid around the eye to treat intraocular inflammation or swelling of

More information

Accent on Health Obgyn, PC HERPES Frequently Asked Questions

Accent on Health Obgyn, PC HERPES Frequently Asked Questions 1. What is herpes? 2. How common is herpes? 3. Is there a cure for herpes? 4. What is oral herpes (cold sores)? 5. How is oral herpes spread? 6. What is genital herpes? 7. How is genital herpes spread?

More information

swine flu vaccination:

swine flu vaccination: swine flu vaccination: what you need to know Flu. Protect yourself and others. Contents What is swine flu?............... 3 About the swine flu vaccine....... 4 What else do I need to know?...... 8 What

More information

Eye Injuries. The Eyes The eyes are sophisticated organs. They collect light and focus it on the back of the eye, allowing us to see.

Eye Injuries. The Eyes The eyes are sophisticated organs. They collect light and focus it on the back of the eye, allowing us to see. Eye Injuries Introduction The design of your face helps protect your eyes from injury. But injuries can still damage your eyes. Sometimes injuries are severe enough that you could lose your vision. Most

More information

1 Always test and record vision wearing distance spectacles test each eye separately A 1mm pinhole will improve acuity in refractive errors

1 Always test and record vision wearing distance spectacles test each eye separately A 1mm pinhole will improve acuity in refractive errors Golden eye rules Examination techniques 1 Always test and record vision wearing distance spectacles test each eye separately A 1mm pinhole will improve acuity in refractive errors Snellen chart (6 metre)

More information

PATIENT INFORMATION LEAFLET. CEFALEXIN 250 mg AND 500 mg CAPSULES CEFALEXIN

PATIENT INFORMATION LEAFLET. CEFALEXIN 250 mg AND 500 mg CAPSULES CEFALEXIN PATIENT INFORMATION LEAFLET CEFALEXIN 250 mg AND 500 mg CAPSULES CEFALEXIN Read all of this leaflet carefully before you start taking this medicine. - Keep this leaflet. You may need to read it again.

More information

Key Facts about Influenza (Flu) & Flu Vaccine

Key Facts about Influenza (Flu) & Flu Vaccine Key Facts about Influenza (Flu) & Flu Vaccine mouths or noses of people who are nearby. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching

More information

Tonsillitis. complications

Tonsillitis. complications and its complications By Paolo Campisi MSc, MD, FRCSC; and Ted L. Tewfik MD, FRCSC Peritonsillar cellulitis and abscess are the most common deep infections of the head and neck in children. Inadequate

More information

State of Kuwait Ministry of Health Infection Control Directorate. Guidelines for Prevention of Surgical Site Infection (SSI)

State of Kuwait Ministry of Health Infection Control Directorate. Guidelines for Prevention of Surgical Site Infection (SSI) State of Kuwait Ministry of Health Infection Control Directorate Guidelines for Prevention of Surgical Site Infection (SSI) September 1999 Updated 2007 Surgical Wound: According to 1998 Kuwait National

More information

2 months Diptheria; Tetanus; Whooping Cough; Hib & Polio 1st dose Pneumococcal Conjugate Vaccination

2 months Diptheria; Tetanus; Whooping Cough; Hib & Polio 1st dose Pneumococcal Conjugate Vaccination IMMUNISATIONS You may want to know if your child should have routine immunisations and whether there could be an increased risk of complications because of the heart condition. We have sought the opinions

More information

Why Do Some Antibiotics Fail?

Why Do Some Antibiotics Fail? Why Do Some Antibiotics Fail? Patty W. Wright, M.D. April 2010 Objective To outline common reasons why antibiotic therapy is not successful and how this can be avoided. And to teach you a little bit about

More information

INFECTION CONTROL MANUAL

INFECTION CONTROL MANUAL Page 1 of 19 Key Words: staff, communicable diseases, diseases, infectious diseases Policy Applies to: All staff employed by Mercy Hospital, Credentialed Specialists and Allied Health Professionals involved

More information

Influenza Vaccine Frequently Asked Questions. Influenza Control Program

Influenza Vaccine Frequently Asked Questions. Influenza Control Program Influenza Vaccine Frequently Asked Questions Influenza Control Program Influenza or the flu can be a serious contagious disease, which is spread by droplet transmission through close contact with an infected

More information

Normal CT scan of the chest

Normal CT scan of the chest Normal CT scan of the chest Heart with left and right ventricle showing up lighter (contrast dye) Breast tissue Breast bone (sternum) Breast tissue Left lung (dark area) Right lung (dark area) Rib Main

More information

Has your young child been crying more than usual and pulling on their ear? If so, your child could have an ear infection.

Has your young child been crying more than usual and pulling on their ear? If so, your child could have an ear infection. Patient information from the BMJ Group Ear infection In this section What is it? What are the symptoms? How is it diagnosed? How common is it? What treatments work? What will happen? Questions to ask Ear

More information

Pneumonia. Pneumonia is an infection that makes the tiny air sacs in your lungs inflamed (swollen and sore). They then fill with liquid.

Pneumonia. Pneumonia is an infection that makes the tiny air sacs in your lungs inflamed (swollen and sore). They then fill with liquid. Pneumonia Pneumonia is an infection that makes the tiny air sacs in your lungs inflamed (swollen and sore). They then fill with liquid. People with mild (not so bad) pneumonia can usually be treated at

More information

Antibiotic Prophylaxis for the Prevention of Infective Endocarditis and Prosthetic Joint Infections for Dentists

Antibiotic Prophylaxis for the Prevention of Infective Endocarditis and Prosthetic Joint Infections for Dentists PRACTICE ADVISORY SERVICE FAQ 6 Crescent Road, Toronto, ON Canada M4W 1T1 T: 416.961.6555 F: 416.961.5814 Toll Free: 1.800.565.4591 www.rcdso.org Antibiotic Prophylaxis for the Prevention of Infective

More information

CLINICAL GUIDELINE FOR

CLINICAL GUIDELINE FOR CLINICAL GUIDELINE FOR the investigation and management of inpatients with discitis (vertebral osteomyelitis) 1. Aim/Purpose of this Guideline 1.1.This guideline applies to clinical staff managing patients

More information

Vaccinations and Spina Bifida and Hydrocephalus

Vaccinations and Spina Bifida and Hydrocephalus shinecharity.org.uk info@shinecharity.org.uk 42 Park Road Peterborough PE1 2UQ 01733 555988 Vaccinations and Spina Bifida and Hydrocephalus Vaccines are made from parts of bacteria or viruses that cause

More information

Is your cold, sore throat, earache or cough getting you down?

Is your cold, sore throat, earache or cough getting you down? Is your cold, sore throat, earache or cough getting you down? Sore throat Blocked nose Sinusitis Runny nose Earache Tonsillitis Cough Cold and Flu A guide to understanding your symptoms Understand your

More information

FOR INFORMATION CONTACT:

FOR INFORMATION CONTACT: NEWS RELEASE FOR INFORMATION CONTACT: Caroline Calderone Baisley Deborah C. Travers Director of Health Director of Family Health Tel [203] 622-7836 Tel [203] 622-7854 September 10, 2014 For Immediate Release

More information

CROSS HEALTH CARE BOUNDARIES MATERNITY CLINICAL GUIDELINE

CROSS HEALTH CARE BOUNDARIES MATERNITY CLINICAL GUIDELINE CROSS HEALTH CARE BOUNDARIES MATERNITY CLINICAL GUIDELINE Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Obstetric Early Warning Score Guideline Implementation

More information

Antimicrobial Prescribing Guidelines for Primary Care 2015

Antimicrobial Prescribing Guidelines for Primary Care 2015 Antimicrobial Prescribing Guidelines for Primary Care 2015 TABLE OF CONTENTS PRINCIPLES OF TREATMENT 3 SUMMARY OF UPDATES TO GUIDELINES 4 UPPER RESPIRATORY TRACT INFECTIONS Influenza 6 Pharyngitis / Sore

More information

Pentavalent Vaccine. Guide for Health Workers. with Answers to Frequently Asked Questions

Pentavalent Vaccine. Guide for Health Workers. with Answers to Frequently Asked Questions Pentavalent Vaccine Guide for Health Workers with Answers to Frequently Asked Questions Ministry of Health and Family Welfare Government of India 2012 Immunization is one of the most well-known and effective

More information

Etiology and treatment of chronic bacterial prostatitis the Croatian experience

Etiology and treatment of chronic bacterial prostatitis the Croatian experience Etiology and treatment of chronic bacterial prostatitis the Croatian experience Višnja Škerk University Hospital for Infectious Diseases "Dr. Fran Mihaljevic" Zagreb Croatia Milano, Malpensa, 14 Nov 2008

More information

Diseases of the middle ear

Diseases of the middle ear Diseases of the middle ear Acute Suppurative Otitis Media: Acute suppurative otitis media may be viral or bacterial and is accompanied by signs of pain, pressure sensation, diminished hearing and occasional

More information

PERTUSSIS SURVEILLANCE AND RESPONSE PROTOCOL

PERTUSSIS SURVEILLANCE AND RESPONSE PROTOCOL PERTUSSIS SURVEILLANCE AND RESPONSE PROTOCOL Public Health Action 1. Educate the public, particularly parents of infants, about the dangers of whooping cough and the advantages of initiating immunization

More information

Where kids come first. Your Child and Ear Infections

Where kids come first. Your Child and Ear Infections 17 Where kids come first Your Child and Ear Infections How common are ear infections? Infection of the middle ear, or otitis media, is the most common affliction requiring medical therapy for children

More information

Leader's Resource. Note: Both men and women can have an STD without physical symptoms.

Leader's Resource. Note: Both men and women can have an STD without physical symptoms. Leader's Resource Information on Sexually Transmitted Diseases (STDs) Signs and Symptoms of STDs Note: Both men and women can have an STD without physical symptoms. Any of the following can indicate to

More information

Laboratory confirmation requires isolation of Bordetella pertussis or detection of B. pertussis nucleic acid, preferably from a nasopharyngeal swab.

Laboratory confirmation requires isolation of Bordetella pertussis or detection of B. pertussis nucleic acid, preferably from a nasopharyngeal swab. Pertussis Epidemiology in New Zealand New Zealand has continued to experience outbreaks of pertussis in recent decades. This is in part due to historically low immunisation rates and in part because immunity

More information