E-DRUG: Antibiotic policy for a resource poor setting (2)
-------------------------------------------------
Hi all
In response to Dr Saluja's request, while South Africa would not be
considered a "very resource poor" area, the SA Standard Treatment
Guidelines/Essential Drugs List for Primary Health Care might provide a
good starting point. This STG/EDL set has been used in a number of other
resource-constrained settings, including the Western Sahara.
The 2003 Edition can be downloaded in sections:
Pages 1-56
http://www.doh.gov.za/docs/factsheets/pharma/primary/2006/part1.pdf
Pages 57-135
http://www.doh.gov.za/docs/factsheets/pharma/primary/2006/part2.pdf
Pages 136-200
http://www.doh.gov.za/docs/factsheets/pharma/primary/2006/part3.pdf
Pages 201-272
http://www.doh.gov.za/docs/factsheets/pharma/primary/2006/part4.pdf
Pages 273-340
http://www.doh.gov.za/docs/factsheets/pharma/primary/2006/part5.pdf
Pages 341-376
http://www.doh.gov.za/docs/factsheets/pharma/primary/2006/part6.pdf
Pages 377-390
http://www.doh.gov.za/docs/factsheets/pharma/primary/2006/part7.pdf
Pages 391-415
http://www.doh.gov.za/docs/factsheets/pharma/primary/2006/part8.pdf
Alternatively, the full document (about 1Mb) is accessible at
http://www.doh.gov.za/docs/factsheets/pharma/primary/2006/standard_treatment.pdf
(the file names are strange, but refer to the Second Print, which
contained corrections made in February 2006).
The recommended antimicrobials are unfortunately not contained in a
single section, but this is the full ToC:
TABLE OF CONTENTS
Foreword
Introduction
Acknowledgements
The Essential Drugs Concept
...........................i
How to use this book
..........................iii
Calculating Body Mass Index
...........................v
A guide to patient education in chronic diseases
..........................vi
Peak Expiratory Flow Rates
..........................ix
Flow diagrams:
1 Acute abdominal pain without fever
...........................1
2 Adult with generalised oedema
......................... 2
3 Earache
..........................3
4 Headache
..........................4
5A Sexually transmitted infections - male
......................... 5
5B Secually transmitted infections - female
......................... 6
6 Sore throat
...........................7
7 Vaginal bleeding
...........................8
CHAPTER 1 - DENTAL AND ORAL CONDITIONS
...........................9
1.01 Abscess and caries, dental
...........................9
1.01.1 Abscess, dental
...........................9
1.02 Candidiasis, oral (thrush)
...........................11
1.03 Gingivitis
...........................12
1.03.1 Gingivitis, acute, necrotising, ulcerative
...........................12
1.03.2 Gingivitis, uncomplicated
...........................15
1.04 Herpes stomatitis cold sore, fever blister
...........................16
1.05 Periodontitis
...........................17
1.06 Ulcers, mouth
..........................18
CHAPTER 2 - GASTRO-INTESTINAL CONDITIONS
..........................19
2.01 Abdominal pain, dyspepsia, heartburn, indigestion
..........................19
2.02 Anal conditions
..........................21
2.02.1 Anal fissures
..........................21
2.02.2 Haemorrhoids
..........................22
2.03 Appendicitis
..........................23
2.04 Cholera
........................23
2.05 Constipation
.......................24
2.06 Diarrhoea , acute
.......................25
2.06.1 Diarrhoea acute, in children
.......................26
2.06.2 Diarrhoea, acute, without blood, in adults
.....................29
2.06.3 Diarrhoea, chronic, in adults
.....................29
2.07 Dysentery
.....................30
2.07.1 Dysentery, amoebic
.....................30
2.07.2 Dysentery, bacillary (shigellosis)
.....................31
2.08 Giardiasis
.....................33
2.09 Helminthic infestations
.....................34
2.09.1 Helminthic infestation, tapeworm
.....................34
2..09.2 Helminthic infestation, excluding tapeworm
.....................35
2.10 Nausea and vomiting, non-specific
.....................36
2.11 Typhoid fever
.....................38
CHAPTER 3 - ENDOCRINE SYSTEM
.....................40
3.01 Diabetes mellitus
.....................40
3.01.1 Diabetes mellitus type 1 in children
.....................40
3.01.2 Diabetes mellitus type 1 in adults
.....................44
3.01.3 Diabetes mellitus type 2
......................46
CHAPTER 4 - NUTRITIONAL AND BLOOD CONDITIONS
......................53
4.01 Anaemia
......................53
4.01.1 Anaemia, iron deficiency
......................54
4.01.2 Anaemia, macrocytic or megaloblastic
......................55
4.01.3 Folate deficiency
.....................56
4.02 Childhood malnutrition and anaemia, including failure to thrive
(FTT) .......56
4.03 Vitamin deficiencies
....................60
4.03.1 Vitamin A deficiency
.....................60
4.03.2 Vitamin B deficiency
.....................62
4.03.2.1 Pellagra (nicotinic acid deficiency)
.....................63
4.03.2.2 Pyridoxine (Vitamin B6) deficiency
.....................64
4.03.2.3 Thiamine deficiency (Wernickes's
encephalopathy and beriberi).....65
CHAPTER 5 - CARDIOVASCULAR CONDITIONS
...................... 67
5.01 Cardiac arrest, cardio-pulmonary resuscitation
.......................67
5.02 Cardiac failure, congestive (CCF)
.......................67
5.02.1 Cardiac failure, congestive (CCF), adults
.......................67
5.02.2 Cardiac failure, congestive (CCF), children
.......................69
5.03 Hypertension
.......................71
5.03.1 Hypertension in adults
........................71
5.03.2 Hypertension in children
........................77
5.04 Ischaemic heart disease, angina pectoris
........................77
5.04.1 Angina, stable
......................77
5.05 Myocardial infarction, acute
......................78
5.06 Pulmonary oedema, acute
......................78
5.07 Rheumatic fever, acute
......................78
5.08 Valvular heart disease and congenital structural heart disease
..................80
CHAPTER 6 - SKIN CONDITIONS
..................82
6.01 Acne vulgaris
..................82
6.02 Bacterial infections of the skin
...................83
6.02.1 Boil, abscess
...................83
6.02.2 Impetigo
...................84
6.03 Cellulitis
....................86
6.04 Eczema
....................87
6.04.1 Eczema,
atopic..............87
6.04.2 Eczema, seborrhoeic
....................89
6.04.3 Eczema, acute, moist or weeping
....................90
6.05 Fungal infections of the skin
.....................92
6.05.1 Athlete's foot - tinea pedis
......................92
6.05.2 Candidiasis, skin
.....................93
6.05.3 Ringworm and other tineas
.....................94
6.06 Parasitic infections of the skin
......................95
6.06.1 Lice (pediculosis)
......................95
6.06.2 Scabies
......................97
6.07 Napkin rash
......................98
6.08 Sandworm
......................99
6.09 Urticaria
...................100
CHAPTER 7 - GYNAECOLOGY AND OBSTETRICS
.................102
7.01 Abortion
.................102
7.01.1 Abortion, incomplete, spontaneous
.................102
7.02 Anaemia in pregnancy
.................103
7.03 Bleeding, vaginal
..................105
7.03.1 Abnormal vaginal bleeding during fertile years
..................105
7.03.2 Bleeding, post-menopausal
..................106
7.04 Cracked nipples during breastfeeding
..................106
7.05 Delivery, normal
.................107
7.05.1 Care of the neonate
..................109
7.05.2 Sick neonate and neonatal emergencies
..................110
7.05.3 Neonatal resuscitation
..................111
7.05.4 Prevention of mother to child transmission of HIV
..................115
7.06 Dysmenorrhoea
..................117
7.07 Haemorrhage, antepartum
..................118
7.08 Hormone replacement therapy
................118
7.09 Hypertensive disorders of pregnancy
..................119
7.09.1 Pregnancy in patients with chronic hypertension
..................121
7.10 Labour, pre-term
......................122
7.11 Pregnancy, ectopic
.....................122
7.12 Ulcers, vaginal
.....................123
7.13 Vaginal discharge/lower abdominal pain in women
.....................123
CHAPTER 8 FAMILY PLANNING
.....................124
8.01 Contraception, barrier methods
....................124
Contraception, emergency
....................125
8.03 Contraception, hormonal
....................125
8.03.1 Contraceptives, injectable
....................125
8.03.2 Contraceptives, oral
....................125
8.04 Contraception, intrauterine contraceptive device (IUCD)
................126
CHAPTER 9 RENAL AND URINARY TRACT CONDITIONS
...................127
9.01 Glomerulonephritis, acute
...................127
9.02 Pyelonephritis, acute
...................128
9.03 Urinary tract infection
...................129
CHAPTER 10 INFECTIONS AND RELATED CONDITIONS
................131
10.01 Bilharzia
................131
10.02 Chickenpox
................133
10.03 Cholera
................134
10.04 Dysentery, amoebic
..................134
10.05 Dysentery, bacillary
..................135
10.06 Giardiasis
..................135
10.07 Infection control, antiseptics and disinfectants
.................135
10.08 Malaria
.................136
10.09 Measles
..................144
10.10 Meningitis
...................147
10.11 Mumps
...................147
10.12 Rubella (German measles)
...................148
10.13 Sexually transmitted infections (STI)
....................149
10.13.1 Lice, pubic
....................157
10.13.2 Molluscum contagiosum
....................158
10.13.3 Scabies, genital
......................158
10.13.4 Warts, genital
......................158
10.14 Tick-bite fever
.....................158
10.15 Typhoid fever
......................159
10.16 Tuberculosis
......................159
CHAPTER 11 IMMUNISATION
.......................160
11.01 Vaccines for routine administration
.......................160
11.02 Immunisation schedule
.......................164
11.03 Immunisation by injection
.......................165
11.04 Adverse vaccine reactions
.......................166
11.05 The cold chain
........................167
11.06 The Revised Opened Multi-Dose Vial Policy
........................168
CHAPTER 12 - MUSCULOSKELETAL CONDITIONS
........................171
12.01 Arthralgia
........................171
12.02 Arthritis, rheumatoid
........................171
12.03 Arthritis, septic
........................171
12.04 Gout
........................172
12.04.1 Gout, acute
........................172
12.04.2 Gout, chronic
.......................174
12.05 Osteoarthrosis (osteoarthritis)
.......................175
CHAPTER 13 - CENTRAL NERVOUS SYSTEM CONDITIONS
......................177
13.01 Epilepsy
......................177
13.02 Febrile convulsions
.......................181
13.03 Meningitis
......................181
13.03.1 Meningitis, acute bacterial
......................181
13.03.2 Meningitis meningococcal, prophylaxis
........................183
13.04 Status epilepticus
........................183
CHAPTER 14 - MENTAL HEALTH CONDITIONS
........................184
14.01 Aggressive disruptive behaviour
........................184
14.02 Anxiety and stress related disorders
........................184
14.03 Delirium - acutely confused, aggressive patient
........................184
14.04 Mood disorders
........................184
14.05 Psychosis, acute
........................187
CHAPTER 15 - RESPIRATORY CONDITIONS
.......................191
15.01 Asthma
.......................191
15.01.1 Asthma, chronic
......................191
15.01.2 Bronchitis, chronic and emphysema
......................197
15.01.3 Bronchospasm, acute associated with asthma and
chronic obstructive bronchitis
......................199
15.01.4 Wheezing in children under six years
...............................203
15.01.5 Bronchiolitis, acute in children
...........................204
15.02 Bronchitis, acute, uncomplicated
..........................205
15.03 Common cold and influenza
.........................206
15.04 Cough
........................207
15.05 Croup (laryngotracheobronchitis)
.........................207
15.06 Pneumonia
........................210
15.06.1 Pneumonia in children
........................211
15.06.2 Pneumonia, mild in adults
......................213
15.06.3 Pneumonia in adults with underlying medical
conditions or over 60 years
.......................214
15.06.4 Pneumonia, severe in adults
.......................214
15.07 Pneumocystis carinii pneumonia
.......................215
15.07.1 Pneumocystis carinii pneumonia (PCP) in children
.....................215
15.07.2 Pneumocystis carinii pneumonia in adults
.......................216
15.08 Tuberculosis
........................217
CHAPTER 16 - EYE CONDITIONS
......................225
16.01 Conjunctivitis
.....................225
16.01.1 Conjunctivitis, allergic
.........................225
16.01.2 Conjunctivitis, bacterial (excluding conjunctivitis of the
newborn) ...226
16.01.3 Conjunctivitis, viral (pink
eye)..........227
16.02 Conjunctivitis, of the newborn (ophthalmia neonatorum)
..........................229
16.02 .1 Conjunctivitis, gonococcal
...........................229
16.02.2 Conjunctivitis, non-gonococcal
............................230
16.03 Eye injuries
............................230
16.03.1 Eye injury, chemical burn
............................230
16.03.2 Eye injury, foreign body (blunt or penetrating)
.............................232
16.04 Glaucoma...........234
16.05 Occupational hazards and trauma, prevention
...........................234
16.06 Visual problems
..........................235
16.07 Xerophthalmia, prevention
........................237
CHAPTER 17 - EAR, NOSE AND THROAT CONDITIONS
...........................239
17.01 Allergic rhinitis (hay fever)
..........................239
17.02 Epistaxis
.........................240
17.03 Otitis
.......................240
17.03.1 Otitis externa
......................240
17.03.2 Otitis media, acute
......................242
17.03.3 Otitis media, chronic, suppurative
......................244
17.04 Sinusitis, acute
......................246
17.05 Tonsillitis and pharyngitis
...................248
17.05.1 Pharyngitis, viral
....................248
17.05.2 Tonsillitis, bacterial
....................249
CHAPTER 18 - SIGNS AND SYMPTOMS
.....................251
18.01 Arthralgia
....................251
18.02 Convulsions, febrile
.....................252
18.03 Cough
.....................254
18.03.1 Cough in children over 5 years and adults
.....................254
18.03.2 Cough associated with difficulty in breathing
in children
...............256
18.04 Fever
................259
18.05 Headache, mild, non-specific
..................261
18.06 Insomnia
....................262
18.07 Itching (pruritus)
....................263
18.08 Jaundice
...................264
18.09 Pain control
....................265
18.09.1 Chronic pain control in advanced or incurable cancer
................267
CHAPTER 19 - TRAUMA AND EMERGENCIES
...................272
19.01 Angina pectoris, unstable
.....................272
19.02 Bites and stings
.....................273
19.02.1 Animal and human bites
......................273
19.02.2 Insect bites and stings
......................278
19.02.3 Snakebite
......................280
19.03 Burns
.....................283
19.04 Cardiac arrest - cardio-pulmonary resuscitation
.....................286
19.04.1 Cardio-pulmonary arrest, adults
.....................286
19.04.2 Cardio-pulmonary arrest, children
.....................289
19.05 Delirium with acute confusion and aggression
.....................293
19.06 Exposure to poisonous substances
.....................295
19.07 Eye, chemical burn
.....................300
19.08 Eye injury, foreign body
.....................300
19.09 HIV prophylaxis, post exposure (PEP)
.....................300
19.09.1 Penetrative sexual abuse or sexual assault
......................300
19.09.2 Occupational post-exposure HIV prophylaxis to
health care workers (HCW)
......................304
19.10 Hyperglycaemia and ketoacidosis
......................306
19.11 Hypoglycaemia and hypoglycaemic coma
......................306
19.12 Injuries
......................308
19.13 Myocardial infarction, acute (AMI)
......................310
19.14 Nose bleed (epistaxis)
......................312
19.15 Pulmonary oedema, acute
......................313
19.16 Shock
......................314
19.17 Shock, anaphylactic
......................315
19.18 Sprains and strains
......................317
19.19 Status epilepticus
......................318
CHAPTER 20 - HUMAN IMMUNODEFICIENCY VIRUS AND ACQUIRED
IMMUNODEFICIENCY SYNDROME
(HIV/AIDS)............321
20.01 Human immunodeficiency virus infection in adults
......................321
20.01.1 Opportunistic infections, prophylaxis in adults
......................323
20.01.2 Opportunistic infections, treatment in adults
......................324
20.02 Human immunodeficiency virus infection in children
......................330
20.02.1 Opportunistic infections, prophylaxis in children
......................333
20.02.2 Opportunistic infections, treatment in children
......................334
20.2.3 Developmental delay or deterioration
......................335
20.2.4 Anaemia
......................335
20.3 Palliation
......................335
Guideline on EDL review process and submission for amendments
.......................336
Disease notification procedures
.......................344
Guidelines for Adverse Drug Events Reporting
........................348
Index of Disease and Conditions
........................353
Index of Drugs
........................359
Abbreviations
........................364
An updated version is expected to be launched this year (2009) and will
be made available on the DoH web site (http://www.doh.gov.za).
regards
Andy