Important: Therapy
Amoxicillin oral 500mg to 1g 8 hourly
Or
Doxycycline oral 200mg stat on first day then 100mg daily
Duration 5 days then review
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.
Dependant on severity
Amoxicillin oral 500mg to 1g 8 hourly
Or
Doxycycline oral 200mg stat on first day then 100mg daily
Duration 5 days then review
Amoxicillin oral 500mg to 1g 8 hourly
If Legionella, Mycoplasma or other atypical bacterial pathogens suspected, add Clarithromycin oral 500mg 12 hourly
Use IV if oral route unavailable.
Switch to oral antibiotics as soon as clinically appropriate
If penicillin allergy,
Doxycycline oral 200mg stat on first day then 100mg daily
Or
Clarithromycin oral 500mg 12 hourly (IV if oral route unavailable)
Duration 5 days then review.
Co-amoxiclav IV 1.2g 8 hourly
+
Clarithromycin oral or IV 500mg 12 hourly
If penicillin allergy
Levofloxacin oral or IV 500mg 12 hourly
Total duration 5 days then review
May need to be extended to 14-21 days according to clinical judgement e.g. if suspected/confirmed “atypical” pathogen, Legionella, Staphylococcal or Gram negative bacilli.
Assess CURB-65 score.
Consider sending throat swab in viral transport medium for viral studies and urine in white-topped universal for Legionella antigen.
Fluroquinolones
Refer to important safety information for all quinolones prior to prescribing.
See MHRA Drug Safety Update January 2024: Fluoroquinolones must only be used in situations when other antibiotics, that are commonly recommended for the infection, are inappropriate such as: