Infection
Dacryocystitis
Antibiotic Therapy (before prescribing, carefully read the Notes / Comments section below)

First line:

Co-amoxiclav oral 625mg 8 hourly for 7 days

Co-amoxiclav is an agent associated with a higher risk of C. difficile infection.*

Second line:

Levofloxacin oral 500mg 12 hourly for 7 days

In pregnant patients, levofloxacin is contraindicated - discuss appropriate empirical choices with an infection specialist.

Levofloxacin is an agent associated with a higher risk of C. difficile infection.*
Notes / Comments

*Major risk factors for C. difficile infection (CDI):

Certain persons are at increased risk of acquiring CDI.

The possibility of CDI should be considered when persons with diarrhoea also have:

  • Current or recent (within the last three months) use of antimicrobial agents (especially those with a high risk for CDI, e.g. cephalosporins, broad spectrum penicillins, fluoroquinolones and clindamycin);
  • Increased age (>65 years old);
  • A previous diagnosis of CDI;
  • Prolonged hospital stay;
  • Serious underlying diseases;
  • Surgical procedures (in particular bowel procedures);
  • Immunosuppression (including HIV infection and transplant patients); and/or
  • Use of proton pump inhibitors (PPI)/H2 antagonists (drugs which reduce the production of stomach acid).

 

 

Guideline reviewed August 2023
Page updated March 2024



;