Important: Therapy
Co-amoxiclav oral 625mg 8 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.
3 days for prophylaxis
5 days for treatment (course length can be increased to 7 days with review based on clinical assessment of the wound)
Co-amoxiclav oral 625mg 8 hourly
Doxycycline oral 100mg every 12hours
+
Metronidazole oral 400mg 8 hourly
Erythromycin oral 500mg every 12 hours
+
Metronidazole oral 400mg 8 hourly
and seek specialist advice
Consult Microbiologist if animal species is other than a dog or a cat.
Consider antimicrobial prophylaxis for the following: human bites, bites to the hand, foot or face, deep/puncture wounds, wounds requiring surgical debridement, bites to high risk patients e.g. diabetics, immunocompromised, prosthetic valve. The choice of antimicrobial for prophylaxis is the same as used for treatment.
For management of high risk tetanus prone wounds discuss with Consultant Microbiologist.
Rabies
There is currently deemed to be no risk from rabies from contact with terrestrial mammals (other than imported animals) in the UK. Bats in the UK may carry rabies-like viruses and contact with them needs to be assessed. Scottish Health Protection Network guidance is currently being updated. In the meantime Public Health England guidance is available on this site:
https://www.gov.uk/government/publications/rabies-post-exposure-prophylaxis-management-guidelines
Details on rabies risk in different countries can be found at