Important: Therapy
Treat as Community Acquired Pneumonia
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.
5 days and review
Treat as Community Acquired Pneumonia
Low Severity
Doxycycline 200mg oral on first day then 100mg daily
OR
Co-trimoxazole 960mg oral 12 hourly
High Severity
Amoxicillin 1g IV 8 hourly
+
Gentamicin IV (Extended Interval Dosing as per guideline. Use gentamicin calculator). Max 3 days then review.
Penicillin allergy OR previous MRSA
Vancomycin (dosing as per guideline. Use vancomycin calculator)
+
Gentamicin IV (Extended Interval Dosing as per guideline. Use gentamicin calculator). Max 3 days then review.
Doxycycline 200mg oral on first day then 100mg daily
OR
Co-trimoxazole 960mg oral 12 hourly
New lung infiltrates on chest X-ray PLUS evidence of infection
Severity Assessment
Treat as high severity if two or more of:
Chest X-ray PLUS in high severity disease:
Viral throat swab (swab throat and nose at same time with single swab, send in viral transport medium)
Reassess daily and discuss with Microbiology if failing to respond after 48-72 hours.
Likely organisms; S. pneumonia (50% HAP), S.aureus, Coliforms, viruses, occasionally Pseudomonas spp.
If patient has been given a course of doxycycline in the past 30 days, consider alternative treatments.