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Microsoft word - hhft orthopaedic infections

ORTHOPAEDIC INFECTIONS
Condition
Useful information
First line
Second line
Duration
EITHER Teicoplanin ω IV
Acute Septic
Benzylpenicillin IV
Arthritis
PLUS Flucloxacillin IV 800mg) 12hourly for 3
Osteomyelitis
PLUS EITHER Sodium OR Doxycycline PO
fusidateΩ tablets PO
OR RifampicinΩ PO
PLUS EITHER Sodium
fusidateΩ
tablets PO
500mg 8hourly
OR RifampicinΩ PO
300–600mg 12hourly
Difficult to treat with antibiotics alone. Osteomyelitis
Choice and route of antibiotics will depend on microbiology results and advice. Teicoplaninω IV 10mg/kg
Discitis
Flucloxacillin 2g IV
PLUS EITHER Sodium 12hourly for 3 doses then
Epidural
fusidateΩ PO 500mg
PLUS EITHER Sodium
OR RifampicinΩ PO
fusidateΩ PO 500mg
OR RifampicinΩ PO
If Gram-negative infection
suspected:
ADD Gentamicin*
IV
5mg/kg 24hourly
ω See Teicoplanin guidelines. Dose on actual body weight. Monitoring is required in renal failure and 10mg/kg dosing Monitor liver function tests at least weekly
Produced by the Antimicrobial Management Team 2012. These guidelines are not comprehensive – consult a
Microbiologist if advice required. For dosing in renal / hepatic failure, seek advice from a pharmacist Page 1 of 3
ORTHOPAEDIC INFECTIONS
Condition
Useful information
First line
Second line
Duration
Flucloxacillin IV 1-2g
Clindamycin¥ § IV 600mg
fractures
/Major trauma
fractures:
as possible ideally
PLUS Metronidazole
Grade II and III wounds:
within 3 hours of
PLUS Gentamicin* IV
Grade I: open
Grade II and III
wounds: PLUS
Gentamicin* IV 5mg/kg
Grade III
wounds:
continue
Grade II: open
Grade III: either open
an open fracture with extensive soft tissue damage or a traumatic amputation Flucloxacillin IV 2g
Teicoplanin ω IV
Bursitis
≥70Kg weight: 600mg
PLUS Clindamycin¥ §
<70 Kg weight: 400mg
doses then 24hourly

CONSIDER ADDING
Sodium fusidateΩ
PO
500mg 8hourly
ω See Teicoplanin guidelines. Dose on actual body weight. Monitoring is required in renal failure and 10mg/kg dosing Monitor liver function tests at least weekly
Produced by the Antimicrobial Management Team 2012. These guidelines are not comprehensive – consult a
Microbiologist if advice required. For dosing in renal / hepatic failure, seek advice from a pharmacist Page 2 of 3
ORTHOPAEDIC INFECTIONS
Condition
Useful information
First line
Second line
Duration
Prosthetic
ALL patients require
Joint Infection deep tissue samples
Antibiotics should
Discuss with
NOT be given until
microbiology
samples have been
therapy unless
taken unless patient
is septic
Two Stage
Teicoplanin ω IV
Procedure
Debride-
PLUS Gentamicin* IV
retention
(DAIR): up
Stop Gentamicin after
Teicoplanin until final
seek advice from
Microbiology
Switch to oral
according to
microbiology results
ω See Teicoplanin guidelines. Dose on actual body weight. Monitoring is required in renal failure and 10mg/kg dosing Monitor liver function tests at least weekly
Produced by the Antimicrobial Management Team 2012. These guidelines are not comprehensive – consult a
Microbiologist if advice required. For dosing in renal / hepatic failure, seek advice from a pharmacist Page 3 of 3

Source: http://staging.hampshirenhs.precedenthost.co.uk/media/16945/hhft_orthopaedic_infections.pdf

Microsoft word - crown_history_final.doc

COMPANY: Crown Laboratories, Inc. provides pharmaceutical and ethical OTC products to the medical marketplace. Crown competes in the $3 billion world pharmaceutical industry. Crown markets its products under the names of Del-Ray Dermatologicals and Med-Derm Pharmaceuticals. Crown also provides contract manufacturing to the pharmaceutical industry. MISSION STATEMENT: To continue to b

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d es en g ag em en t s d’ h i er au x P r at i q u es act u el l es : P o u r l i b ér er l’a m o u r e t l a s e x ua l i t é … | 2011 | au t eu r e : F r éd o u b r au n1La dimension sexuel e dans les relations entre individu.e.s a une place et un rôle particuliers dans la société humaine. El e existe bien sûr depuis l’aube de l’humanité, mais s’impose à nous – curieuse

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