Goodfellow Gems

What is a GEM?

Gems are chosen by the Goodfellow director Dr Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice. ©The Goodfellow Unit. Here is one example.

Highlights from 2017 BPAC antibiotic guide

Shorter courses of antibiotics, more intensive dosing regimens and reserving broader spectrum antibiotics for specific scenarios.
- Sinusitis: Most cases are not bacterial - consider inhaled nasal steroid.2 Consider antibiotics when symptoms that persist for more than ten days, severe symptoms or fever (>39 °C) and purulent nasal discharge or facial pain lasting for at least three consecutive days, or onset of worsening symptoms after initial improvement. Amoxil first line.
- Impetigo: antiseptics first line (hydrogen peroxide 1% cream or povidone-iodine 10% ointment for 5 days. Topical antibiotics are strongly discouraged. Oral antibiotics second line or for widespread infection.
- Cellulitis now shorter at 5 days with flucloxacillin 500 mg QID.
- Amoxicillin clavulanate first line for diabetic foot infections and human/animal bite if infected.
- Diverticulitis: mild cases don’t need antibiotics; if needed then trimethoprim + sulfamethoxazole 960 mg, twice daily, with metronidazole, 400 mg, three times daily, for five days.
references online