Important: Therapy
Vancomycin Oral 125mg 6 hourly
28 june 2024
Our eHealth team advised us yesterday of an international vulnerability relating to polyfill.io . This domain has become compromised and is spreading malware through a widespread supply chain attack, estimated to affect over 110,000 websites including major websites such as the BBC. The Polyfill site offered widely used bits of code for older browsers that allowed the use of modern Javascript features. Such code makes the work for web developers easier and allows compatibility with a broader range of browsers.
Websites that have used the Javascript code from Polyfill have been urged to remove such code immediately. The change occurred after a suspected Chinese firm purchased the domain in early 2024.
Tactuum have identified and are now testing a fix to remove all Polyfill code from the RDS site.. They will be deploying the fix on Monday 1 July along with other planned fixes and amendments. I will notify you of the timing of the deployment as soon as possible.
In the meantime, please ensure that you have up-to-date anti-virus software installed on your machines and personal devices.
10 days
Vancomycin Oral 125mg 6 hourly
Discuss with Infection Specialist. Treatment will depend on severity and clinical setting.
Fidaxomicin Oral 200mg 12 hourly
Or
Vancomycin oral 500mg 6 hourly
+/- Metronidazole IV 500mg 8 hourly
(IV metronidazole can be reviewed and discontinued if patient improving)
Seek urgent specialist advice, including surgical review
Life threatening CDI is when a patient has any of the following attributable to CDI:
Admission to ICU, hypotension with or without need for vasporessors, ileus or significant abdominal distension, mental status changes, WBC ≥35 x 109 or <2 X 109/L, serum lactate greater than 2.2 mmol/L or end organ failure (mechanical ventilation, renal failure).
Specialists may offer:
Vancomycin Oral 500mg 6 hourly
+/- metronidazole IV 500mg 8 hourly
(IV metronidazole can be reviewed and discontinued if patient responds well)
- evidence of severe colitis in CT scan or X-ray
- Temperature >38.5 °C
- suspicion or/confirmed pseudomembranous colitis, toxic megacolon or ileus
- acute rising serum Creatinine .1.5 x baseline
- WBC>15 x 109/L
- drinking enough fluids to avoid dehydration
- preventing the spread of infection
- seeking medical help if symptoms worsen rapidly or significantly at any time