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Cover Design
John Michael L. Roque
Layout Design
Adell R. Azuelo
Lora Alaine D. Raymundo
John Michael L. Roque
All rights reserved 2017
National Antibiotic Guidelines Committee
Pharmaceutical Division
Department of Health
Philippine Blood Center, Lung Center Compound, Quezon Avenue, Quezon City, 1100
ISBN - 978-621-95675-1-0
Any part of the book or its entirety may be reproduced or transmitted without any alteration, in any form or by any means, with permission from DOH provided it is not used for commercial purposes.
National Antibiotic
Guidelines
2017
Department of Health
Manila, Philippines
TABLE OF CONTENTS
MESSAGE OF THE SECRETARY OF HEALTH ................................................. i ACKNOWLEDGMENTS ................................................................... ii
EDITORIAL TEAM ..................................................................................... iv
ACRONYMS AND ABBREVIATIONS ............................................................ v INTRODUCTION TO THE NATIONAL ANTIBIOTIC GUIDELINES ..................... viii BLOOD-BORNE INFECTIONS AND OTHER SYSTEMIC SYNDROMES ............. 1
PUBLIC HEALTH PROGRAMS
i ii
ACKNOWLEDGMENTS
The participation and assistance of the following experts and reviewers of this document are gratefully acknowledged: Dr. Estrella B. Paje-Villar, former NAG Committee Chair
Dr. Ivan Olegario, former editor
DOH offices:
Disease Prevention and Control Bureau (DPCB)
Epidemiology Bureau (EB)
Food and Drug Administration (FDA)
Health Facility Development Bureau (HFDB)
Professional Associations:
Pediatric Infectious Disease Society of the Philippines Pediatric Nephrology Society of the Philippines (PNSP)
Philippine Academy of Family Physicians (PAFP)
Philippine Academy of Ophthalmology (PAO)
Philippine Academy of Pediatric Pulmonologist (PAPP) Philippine Coalition Against Tuberculosis (PhilCAT)
Philippine College of Chest Physicians (PCCP)
Philippine College of Physicians (PCP)
Philippine College of Surgeons (PCS)
Philippine Dental Association (PDA)
Philippine Dermatological Society (PDS)
Philippine Hospital Infection Control Society, Inc. (PHICS)
Philippine Neurological Association (PNA)
Philippine Obstetrical and Gynecological Society (POGS)
Philippine Orthopedic Association (POA)
Philippine Pediatric Society (PPS)
Philippine Pharmacists Association, Inc. (PPhA)
Philippine Society for Microbiology and Infectious Disease (PSMID)
Philippine Society of Nephrology (PSN)
Philippine Society of Newborn Medicine (PSNBM)
Philippine Society of Otolaryngology Head and Neck Surgery (PSO-HNS) Philippine Society for Pediatric Gastroenterology, Hepatology and
Nutrition (PSPGHAN)
iii
Philippine Society of Pediatric Surgeons (PSPS)
Philippine Urological Association (PUA)
Hospitals:
Research Institute for Tropical Medicine (RITM)
San Lazaro Hospital (SLH)
The Medical City (TMC)
UP- Philippine General Hospital (UP-PGH)
Development Partners:
World Health Organization
iv
EDITORIAL TEAM
National Antibiotic Guidelines Committee
Chair
MEDIADORA C. SANIEL, MD, MBA-H, FPCP
Members
CELIA C. CARLOS, MD, FPPS, FPIDSP, FPSMID
CARMINA A. DELOS REYES, MD, FPPS, FPAPP
MARI ROSE A. DE LOS REYES, MD, FPCP
BENILDA B. GALVEZ, MD, FPCCP
MARY ANN D. LANSANG, MD, MMEDSC
CECILIA C. MARAMBA-LAZARTE, MD, MSCID, MSCCT
ROSALIND G. VIANZON, MD, MPH
CYNTHIA S. FABREGAS, MD, DPCOM
OLIVIA M. LIMUACO, RPh, PhD
YOLANDA R. ROBLES, RPh, PhD
VITO G. ROQUE, Jr. MD
Antimicrobial Resistance Program Secretariat
CORAZON I. FLORES, MD, MPH, CESO IV
ANNA MELISSA M. GUERRERO, MD, MPH (HTA)
IRENE V. FLORENTINO-FARIÑAS, RPH, MD, MNSA
MS. ANNE JULIENNE M. GENUINO, RPH
MS. NIÑA ISABELLE M. TOLENTINO, RPH
MS. LORA ALAINE D. RAYMUNDO, RPH
v
ABBREVIATIONS AND ACRONYMS
ABECB Acute bacterial exacerbation of chronic bronchitis
ABP Acute bacterial prostatitis
ABRS Acute bacterial rhinosinusitis
ABSSSI Acute bacterial skin and skin structure infections
AL Artemether-lumefantrine
ALT Alanine aminotransferase
AOM Acute otitis media
ARSP Antimicrobial Resistance Surveillance Program
ART Antiretroviral therapy
ASB Asymptomatic bacteriuria
AUC Acute uncomplicated cystitis
BMI Body mass index
BUN Blood urea nitrogen
CAMRSA Community associated MRSA
CAP Community acquired pneumonia
CBP Chronic bacterial prostatitis
CHD Congenital heart disease
CMV Cytomegalovirus
CNS Central nervous system
CRP C-reactive protein
CRS Chronic rhinosinusitis
CSF Cerebrospinal fluid
CSOM Chronic suppurative otitis media
CT Computed tomography
CVC Central venous catheter
CVS Cardiovascular system
DAIR Debridement and retention of prosthesis
DEC Diethyl carbamazine
DFI Diabetic foot infections
DOT Duration of Therapy
EIA Enzyme immunoassay
ELISA Enzyme-linked immunosorbent assay
ENT Ears, nose and throat
EPTB Extra pulmonary tuberculosis
ESBL Extended spectrum ß-Lactamase
ESR Erythrocyte sedimentation rate
ETEC Entero-toxigenic Escherichia coli
FDC Fixed dose combination
vi
FQ Fluoroquinolone
FTA-ABS Fluorescent treponemal antibody absorption test
GIT Gastro-intestinal tract
GABHS Group A Beta-hemolytic Streptococci
GAS Group A streptococcus
GCSF Granulocyte stimulating factor
GNB Gram-negative bacteria
GUT Genitourinary tract
HACEK Haemophilus sp., Aggregatibacter sp., Cardiobacterium hominis,
Eikinella corrodens, and Kingella sp.
HAI Hospital-associated Infections
HAP Hospital acquired pneumonia
HBIG Hepatitis B Immunoglobulin
HBeAg Hepatitis B envelope antigen
HBsAg Hepatitis B surface antigen
HBV Hepatitis B virus
HCV Hepatitis C virus
HR Isoniazid + Rifampicin
HRZE/S Isoniazid + Rifampicin + Pyrazinamide +
Ethambutol/Streptomycin
HSV Herpes simplex virus
HIV Human immunodeficiency virus
ICT Immunochromatographic test
IDSA Infectious Diseases Society of America
IE Infective Endocarditis
I & D Incision and drainage
IRIS Immune reconstitution inflammatory syndrome
ISPD International Society for Peritoneal Dialysis
LBW Low birth weight
LP Lumbar puncture
MAP Mean arterial pressure
MDR-TB Multiple drug resistant tuberculosis
MDT Multidrug therapy
MIC Minimum inhibitory concentration
MMR Mumps, Measles, Rubella
MRI Magnetic resonance imaging
MSSA Methicillin-susceptible Staphylococcus aureus
MRSA Methicillin-resistant Staphylococcus aureus
MTB Mycobacterium tuberculosis
NAAT Nucleic acid amplification testing
NBE Nocturnal blood examinations
vii
NT Neutralization test
OC Oral contraceptive
OGTT Oral glucose tolerance test
PANDAS Pediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Streptococcus Infections
PCAP Pediatric community acquired pneumonia
PCR Polymerase chain reaction
PHN Post-herpetic neuralgia
PICC Peripherally inserted central catheter
PID Pelvic Inflammatory Disease
PLHIV People living with HIV
PMDT Programmatic Management for drug-resistant Tuberculosis
PT Prothrombin time
PVL Panton valentin leukocidin
PWID People who inject drugs
RHD Rheumatic Heart Disease
RPR Rapid plasma reagin
RSU Respiratory syncytial virus
SIRS Systemic inflammatory response syndrome
SLDs Second line drugs
SLE Systemic Lupus Erythematosus
SOFA Sequential organ failure assessment
STD Sexually Transmitted Disease
STI Sexually Transmitted Infections
TALF Treatment after lost to follow up
TB Tuberculosis
TMP-SMX Trimethoprim-sulfamethoxazole
TCA Trichloroacetic acid
TSS Toxic shock syndrome
TEE Transesophageal echo
TPHA Treponema pallidum haemagglutination
TTE Transthoracic echocardiogram
ULN Upper limit of normal
UTI Urinary tract infection
VAP Ventilator associated pneumonia
VDRL Venereal Disease Research Laboratory
VP Ventriculoperitoneal
VSD Ventricular septal defect
VZIG Varicella zoster immunoglobulin
VZV Varicella zoster virus
WHO World Health Organization
viii
INTRODUCTION
The National Antimicrobial Stewardship (AMS) Program, an integral component of the Philippine Action Plan to Combat Antimicrobial Resistance (AMR), gives structure and direction to healthcare facilities to adopt a proactive multidisciplinary approach to promote rational antimicrobial use. One of the six core elements of AMS is the development and implementation of policies, guidelines and clinical pathways to improve antimicrobial prescribing and dispensing. Specifically, Core quality of patient care and patient safety. Armed with enhanced knowledge provided by the Guidelines, health practitioners at all levels of healthcare are then empowered to appropriately treat common infectious disease syndromes seen among children and adults (e.g. respiratory and urinary tract infections, diarrhea, skin and soft tissue infections, tuberculosis) as well as other diseases for which much irrational antibiotic use prevails in the country. The challenging task of formulating the Guidelines was given by the Department of Health to the National Antibiotic Guidelines Committee (NAGCOM), a multidisciplinary group of experts in the fields of infectious diseases, epidemiology,quotesdbs_dbs17.pdfusesText_23
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