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Monitoring and discharge therapy – case 6 part 1

The following case is an example of the monitoring which may be required: A 62-year-old patient, prescribed clinically significant immunosuppressive therapy for a severe inflammatory condition, is treated for bloodstream …

Discharge and follow-up arrangements

Patients are discharged when: The planned complex antibiotic therapy course has been completed and the patient does not require further therapy The patient is established and stable enough on the …

Our COPAT service

Our COPAT service currently runs Monday to Friday, 0800 to 1600, although it is hoped that it will expand to a 7-day service soon. This means that there are many …

How we would deal with this problem

We would ask the patient to stop both antibiotics. Ciprofloxacin is well known to cause tendonitis and patients should be warned of the potential for this to occur (as well …

How do we do it?

At Hull University Teaching Hospitals NHS Trust we run three dedicated nurse-led clinics each week seeing up to six patients in each clinic. Patients are also seen at other times …

Who is needed for COPAT?

In an ideal situation, the core and essential members of a COPAT service are: A doctor (preferably with considerable infection expertise) An experienced nurse A pharmacist (preferably with considerable antibiotic …

Other antibiotics

Other antimicrobials, that would not usually be monitored, may need systematic enhanced monitoring within a COPAT or similar service due to comorbidities, drug-drug interactions or other concerns (including adherence). For …

How to monitor Rifampicin – a brief primer

A number of important considerations are required before prescribing Rifampicin: Is a Rifampicin-containing regimen the optimal regimen for the patient’s infection? If yes, are the bacteria thought to be causing …

Tedizolid

We do not use it as a first-line agent, except in selected patients taking high doses of, or multiple, MAOI and/or serotonergic drugs, because of cost considerations (approx. £140 per …

Outcome of case 5

This patient tolerated Chloramphenicol well for 19 weeks, but then developed blurred vision. She was referred to ophthalmology who diagnosed optic neuritis, probably secondary to Chloramphenicol. This was stopped and …

Case 5 – Before prescribing oral chloramphenicol

The patient described in step 3.4 was also taking warfarin for atrial fibrillation. Chloramphenicol interacts with many medications so it is important to check the patient’s current drug list before …

Chloramphenicol

Chloramphenicol is an ‘old’ broad-spectrum antibiotic, available in IV, oral and topical formulations. Not prescribed routinely in the UK, oral Chloramphenicol is on occasions the only oral option for some …