ANTIBIOTIC CHOICE IN THE TREATMENT OF MEASLES WITH COMPLICATIONS

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Broad-spectrum antibiotics for eye drops or eye ointment: Ciprofloxacin or Ofloxacin or Levofloxacin. Corneal Ulcer Oral antibiotics Amoxicillin-clavulanic acid or Cefotaxime or Ceftriaxone intravenously

Broad-spectrum antibiotics for eye drops or eye ointment: Ciprofloxacin or Ofloxacin or Levofloxacin Stomatitis and Oral Ulcers Oral ulcers: Amoxicillin orally with Metronidazole orally at a dose of 7.5mg/kg/time, 3 times a day, for 5 days. Candida infection: Nystatin orally for 7 days.

Pneumonia

1. The bacterial agents causing secondary pneumonia in Measles are commonly Streptococcus pneumoniae, Hemophilus influenza, Staphylococcus:

Initial antibiotics:

– Amoxicillin – clavulanic acid (Oral) or Cefotaxime or Ceftriaxone (IV)

– If there is failure with oxygen cannula: Add Oxacillin (IV) or Cloxacillin (IV) if suspecting MSSA or Vancomycin (IV) if suspecting MRSA

Antibiotics after 48 hours if there is no response to initial antibiotics

– Cefotaxime or Ceftriaxone combined with Vancomycin

– Or Ceftazidime or Cefepime or Levofloxacin or Imipenem or Meropenem combined with Vancomycin/Linezolid (if already treated with Vancomycin)

2. Hospital-acquired pneumonia due to multi-drug resistant bacterial agents Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae ESBL (+), Escherichia coli ESBL(+), MRSA:

Initial antibiotics:

– Use 1 antibiotic resistant to Pseudomonas: Ceftazidime or Cefepime or Levofloxacin combined with Amikacin or Tobramycin.

– Combine with MRSA resistant antibiotic: Vancomycin

Selection of subsequent antibiotics after 48 hours:

– Clinical improvement → continue antibiotics.

– Clinical deterioration and bacterial results (-) or (+) but resistant to the antibiotics being used → Add Colistin in case of suspicion.

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