4.13.2 - Non Surgical

Conditions

Preferred

Alternative

Comments

 
Neisseria meningitides
Household and close contact
 
Ciprofloxacin 500 mg PO as single dose
 
Ceftriaxone 250 mg IM as single dose
OR
Rifampicin 600 mg PO q12H for 2 days

 
Avoid rifampicin in pregnancy.

Close contacts: have had contact with oropharyngeal secretions (e.g. kissing, sharing toys, beverages, cigarettes, intubating).
 
Upper GI bleeding in cirrhosis

 
Ciprofloxacin 500 mg PO q12H 2 - 7 days

 
Ceftriaxone 1 gm IV q24h for 7 days
 
 
Spontaneous bacterial peritonitis
Indication: Previous proven SBP acsitic protein < 10 g/L

 
TMP-SMX (80 mg / 400 mg) 2 tablet PO q24H
 
Norfloxacin 400 mg PO q24H
OR
Ciprofloxacin 500 mg PO q12H

 
Only use norfloxacin if trimethoprim-sulfamethoxazole failed.
 
Asplenia Or Hyposlenia
Pathogen: encapsulated bacteria prophylaxis, recommended for: < 5 year, at least year 3 years post splenectomy, underlying immunocompromised, at least 6 months after an episode of severe sepsis.

 
Amoxycillin 250 mg PO q12H
OR
Phenoxymethylpenicillin 250 - 500 mg PO q12H
 
Erythromycin Ethyl Succinate 400 mg PO q24H
 

Emergency supply of antibiotic for self administration when febrile while seeking physician

 
Amoxycillin 3 gm PO
OR
Amoxycillin / Clavulanate 625 mg PO
 
If taking EES, increase dose to 800 mg PO q12H
OR
Cefuroxime 1 gm PO
OR
Clindamycin 600 mg PO
OR
TMP-SMX (TMP 80 mg / SMX 400 mg) 2 tablet PO

 
 
Vaccination recommendation:
Pneumococcal vaccine



Meningococcal vaccines




Hemophilus influenzae type B Influenza
 

Pneumococcal 23-valentpolysaccharidevaccine 0.5 mL S/C or IM, 5 yearly

Meningococcal quadrivalent polysaccharide ACWY vaccine 0.5 mL S/C, 5 yearly
Hib 0.5 mL IM, Single dose

Influenza vaccine annually

   
> 2 weeks before elective surgery 
OR 7 - 14 days after emergency splenectomy or prior to discharge.