Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- 113 Nonsurgical antimicrobial prophylaxis
- 114 Surgical prophylaxis
- 115 Immunizations
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
113 - Nonsurgical antimicrobial prophylaxis
from Part XV - Prevention of infection
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- Part XV Prevention of infection
- 113 Nonsurgical antimicrobial prophylaxis
- 114 Surgical prophylaxis
- 115 Immunizations
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
Prevention
Chemoprophylaxis is the use of an antimicrobial agent to prevent infection. Chemoprophylaxis is often administered after exposure to a virulent pathogen or before a procedure associated with risk of infection. Chronic chemoprophylaxis is sometimes administered to persons with underlying conditions that predispose to recurrent or severe infection. Antibiotics can also be used as pre-emptive therapy (sometimes referred to as secondary prophylaxis) to prevent clinical disease in persons infected with a microorganism such as Mycobacterium tuberculosis. Immunization, another excellent means of preventing infection, is discussed in Chapter 115. For information on prophylaxis of bacterial endocarditis, see Chapter 37, Endocarditis of natural and prosthetic valves: treatment and prophylaxis; for information on prophylaxis in persons infected with the human immunodeficiency virus (HIV), see Chapter 102, Prophylaxis of opportunistic infections in HIV disease; for malaria prophylaxis, see Chapter 200, Malaria; for prophylaxis related to transplant recipients and neutropenic patients, see Chapter 89, Infections in transplant recipients, and Chapter 85, Infections in the neutropenic patient; and for surgical prophylaxis, see Chapter 114, Surgical prophylaxis.
Several concepts are important in determining whether chemoprophylaxis is appropriate for a particular situation. In general, prophylaxis is recommended when the risk of infection is high or the consequences significant. The nature of the pathogen, type of exposure, and immunocompetence of the host are important determinants of the need for prophylaxis. The antimicrobial agent should eliminate or reduce the probability of infection or, if infection occurs, reduce the associated morbidity. The ideal agent is inexpensive, orally administered in most circumstances, and has few adverse effects. The ability to alter the normal microbiota and select for antimicrobial resistance should be limited. The emerging crisis of antibiotic-resistant bacteria underscores the importance of rational and not indiscriminate use of antimicrobial agents.
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- Clinical Infectious Disease , pp. 746 - 751Publisher: Cambridge University PressPrint publication year: 2015