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Chapter-06 Prophylaxis and Immunizations

BOOK TITLE: Antibiotic Essentials

Author
1. Cunha Burke A.
2. Hage Jean E.
3. Brusch John L.
4. Nichols Ronald L.
5. Gran Arthur
6. Gardner Pierce
7. Fischer Staci A.
8. Wu Gina L.
9. Raza Muhammed
10. Mileno Maria D.
ISBN
9789385999079
DOI
10.5005/jp/books/14129_7
Edition
15/e
Publishing Year
2018
Pages
32
Author Affiliations
1. Winthrop-University Hospital, Mineola, New York; State University of New York, School of Medicine, Stony Brook, New York, Winthrop-University Hospital, Mineola, New York; State University of New York School of Medicine, Stony Brook, New York
2. Winthrop-University Hospital, Mineola, New York, State University of New York, School of Medicine, Stony Brook, New York, Winthrop-University Hospital, Mineola, New York and State University of New York School of Medicine, Stony Brook, New York, Winthrop-University Hospital, Mineola, New York
3. Cambridge Health Alliance, Infectious Disease Service, Cambridge Health Alliance; Somerville Hospital; Harvard Medical School, Boston, Massachusetts, Cambridge Health Alliance; Somerville Hospital; Harvard Medical School, Boston, Massachusetts, Cambridge Health Alliance; Harvard Medical School, Boston, Massachusetts
4. Tulane University School of Medicine, New Orleans, Louisiana
5. Winthrop-University Hospital, Mineola, New York, State University of New York, School of Medicine, Stony Brook, New York, Winthrop-University Hospital, Mineola, New York and State University of New York School of Medicine, Stony Brook, New York, Winthrop-University Hospital, Mineola, New York
6. National Institutes of Health, John E. Fogarty International Center for, Advanced Study in the Health Sciences, Bethesda, Maryland, National Institutes of Health, John E. Fogarty International Center for Advanced Study in the Health Sciences, Bethesda, Maryland
7. Rhode Island Hospital; Brown University Alpert School of Medicine, Providence, Rhode Island
8. Winthrop-University Hospital, Mineola, New York
9. Winthrop-University Hospital, Mineola, New York
10. The Miriam Hospital; Brown University Alpert School of Medicine, Providence, Rhode Island
Chapter keywords
Prophylaxis, surgical prophylaxis, post-exposure prophylaxis, HIV, chronic medical prophylaxis, HIV opportunistic infection, transplant prophylaxis, travel prophylaxis, malaria prophylaxis, immunization

Abstract

This chapter seeks to familiarize the readers with prophylaxis and immunizations. Prophylaxis is most likely to be effective when given for a short duration against a single pathogen with a known sensitivity pattern, and least likely to be effective when given for a long duration against multiple organisms with varying/unpredictable sensitivity patterns. The only difference between prophylaxis and therapy is the inoculum size and the duration of antibiotic administration. Some infectious diseases can be prevented by post-exposure prophylaxis (PEP). To be maximally effective, PEP should be administered within 24 hours of the exposure, since the effectiveness of prophylaxis more than 24 hours after exposure decreases over time. Endocarditis prophylaxis is now recommended only for previous endocarditis, prosthetic cardiac valve or prosthetic cardiac valve material, congenital heart disease (CHD), unrepaired cyanotic CHD, repaired CHD with residual defects adjacent to the site of prosthetic patch/device, and cardiac transplantation with cardiac valvupathy. Recommendations to prevent infection in travelers consist of general travel precautions, and specific travel prophylaxis regimens. Immunizations are designed to reduce infections in large populations, and may prevent/decrease the severity of infection in non-immunized individuals. Immunizations are not fully protective, but are recommended (depending on the vaccine) for most normal hosts, since some protection is better than none.

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