UTI prophylaxis

< 3y old, after first episode of UTI OR Recurrent UTI:

Trimethoprim oral, once daily at night

If trimethoprim resistant, discuss with Microbiologist

Review every 3-6 months

Breakthrough infections are due to non-compliance or true antimicrobial resistance

If breakthrough infection occurs, review sensitivity of isolates before restarting antibiotic prophylaxis

Splenectomy

Also hyposplenia or asplenia

See NHS Fife splenectomy guidance here

Meningococcal meningitis - contacts

Always discuss with on-call Consultant in Public Health Medicine (CPHM) without delay when clinical diagnosis has been made

Healthcare workers in close contact with the patient during for example mouth-to-mouth resuscitation and likely to have been exposed to respiratory secretions should be offered prophylaxis

Ciprofloxacin PO - Please review the MHRA Safety Advice before prescribing

For close contacts who are / may be pregnant

Ceftriaxone IM 250 mg stat

or

Ciprofloxacin PO can be used - Please review the MHRA Safety Advice before prescribing

Prophylaxis is also recommended for the index case to eradicate nasopharyngeal carriage if they were not treated with ceftriaxone

Haemophilus meningitis - contacts

Always discuss with on-call Consultant in Public Health Medicine (CPHM) without delay when clinical diagnosis has been made.

Rifampicin PO