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CHEMOPROPHYLAXIS Dr Sangeetha P
CHEMOPROPHYLAXIS  Definition  The Practice of administering an antimicrobial agent for preventing an infection  or  for suppressing contacted infection before the clinical manifestations.
Influencing factors
. Prophylaxis effective when  Single pathogen  Acute exposure  Short duration prophylaxis  Suitable drug  Lethal disease
Ineffective prophylaxis leads to ,[object Object]
Resistant organisms
 Economic waste
 Risk of side effects,[object Object]
Types of prophylaxis
Classification
Disease targeted prophylaxis ,[object Object]
Endocarditis
Malaria
Cholera
Plague
Influenza ,[object Object]
Neutropenia
Asplenia
Haemoglobinopathy,[object Object]
Surgical prophylaxis To prevent Surgical Site Infection (SSI); not all infections  occuring  in  the  post-op  period..  Staphylococcus  -  Cefazolin
Rheumatic fever ,[object Object],  Treating streptococcal pharyngitis ,[object Object],    Preventing a second episode of pharyngitis
Streptococcal pharyngitis ,[object Object]
Oral Erythromycin for 10 daysInj Benzathine Penicillin 6L IM single dose
Secondary  ,[object Object]
Sulfadiazine 500mg OD
Erythromycin 250mg BDInj.Benzathine Penicillin 1.2L IM 4 weekly
Endocarditis  High morbidity Dental /Surgical procedures with bleeding from mucosa.. 2007 AHA guidelines Choice of drug depend on the flora..
Endocarditis . Upper GIT Alpha hemolytic streptococci Ampicillin/Amox/ clindamycin
Endocarditis  . Lower GIT ENTEROCOCCI Ampi+Genta Vanco+Genta Ampi/Amox
Antibiotic Regimens for Prophylaxis of Endocarditis in Adults with High-Risk Cardiac Lesions A. Standard oral regimen   1. Amoxicillin 2.0 g PO 1 h before procedure B. Inability to take oral medication   1. Ampicillin 2.0 g IV or IM within 1 h before procedure C. Penicillin allergy   1. Clarithromycin or azithromycin 500 mg PO 1 h before procedure   2. Cephalexin 2.0 g PO 1 h before procedure   3. Clindamycin 600 mg PO 1 h before procedure D. Penicillin allergy, inability to take oral medication   1. Cefazolinor ceftriaxone1.0 g IV or IM 30 min before procedure   2. Clindamycin 600 mg IV or IM 1 h before procedure
Malaria  Chloroquine sensitive ,[object Object],    Start 2 weeks prior & continue for 4weeks after travel..
Malaria  Chloroquine resistant ,[object Object]
Mefloquine 250mg weekly

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