MEDICALLY IMPORTANT FUNGI and ANTIFUNGAL THERAPY DR. BREIDA BOYLE.
Choosing theright antibiotic and antifungal · Choosing the right antibiotic and antifungal Dr....
Transcript of Choosing theright antibiotic and antifungal · Choosing the right antibiotic and antifungal Dr....
Choosing the right antibiotic and antifungal
Dr. Srilal De Silva
Dr. Srikanth Giri
Dr. Poonam Dalal
Dr. Arun Shah
Dr. Jatinder
Dr. Prakash Sanghvi
Moderator : Arvind Shenoi
More than 50 publications/presentations(National/International)
Certified instructor: FBNC, Basic & Advanced NRPand Indian Academy of Pediatrics (IAP)-ALS, IAP-ALS-MAP
Co-investigator: Nation-wide project titled
Dr. Poonam DalalMBBS, MD (Pediatrics)
Professor, Deptt of PediatricsPt. BDS, PGIMS, Rohtak, Haryana
Special Interest: NEONATOLOGY
CV- Dr Prakash SanghaviName : Dr. Prakash B. Sanghavi
Qualification : MB , DCH, FCPS (Ped. ) MNAMS, FIAP
Designation : Neonatologist & Pediatrician ,
Vice President - COMHAD International (Asia)
Ex- President - COMHAD India Chapter
Ex President - Maharashtra – NNF
Chairman – Swastik - Komal Health Care Limited
Chairman – Sanghavi Hospital , Kolhapur
National Co-ordinator – NALS
National Co-ordinator - KMC
Institution : Sanghavi Hospital & Premature Baby Care Centre, Kolhapur.
Swastik - Komal Health Care Limited, Kolhapur.
Area of Interest : Research In Neonatology
Prevention of Developmental Disability
Community Neonatology
Early Intervention in Developmental Disability
Publications : Maternal & Child Health Care, Vaccination, New-born Care, Prematurity,
Breast feeding, New-born Feeding, Neonatal sepsis,, Genetic Disorders,
New-born screening, Cerebral Palsy, literatures on Polio Eradication Programs.
Awards: Many Awards in Special Innovations in Neonatology,
FIAP by Indian Academy of Pediatrics
Head of Pediatric Department (Prasad Hospital)
Consultant Pediatrician Muzaffarpur
Dr Arun ShahMD DCH FRCP FIAP FNNF FIAMS
Area of interest : Neonatology
Arvind Shenoi
Consultant neonatologist and Medical DirectorCloudnine Hospital Bangalore
MD (Pediatrics) DM Neonatology(PGIMER)
Neonatal sepsis, Vitamin D in neonatal nutrition
Learning objectives
• Early onset and late onset sepsis
• Multi-drug resistant sepsis
• When to fungal infection/ mixed infection?
• Fungal meningitis & arthritis
• Culture negative sepsis
Case 1
• A 35 week 1.3 kg male neonate – 36 hours ROM, foul smelling liquourwith a mother with febrile UTI
• What antibiotic/s and why
• GBS – do you screen ? Role of prophylaxis
• When not to give antibiotics ?
Case 2
• Full term 2.3 Kg female neonate – admitted to NICU with hypoglycemia, feeding issues, worsened on day 5 with signs of shock, tachypnea and increasing feed intolerance.
• Which antibiotic?
• Will you consider an antifungal?
• If this neonate was 2 weeks old and had oral thrush
Case 3
• Baby born in a peripheral hospital- 2.7kg term, had respiratory distress at birth – given iv fluids, oxygen.
• Deteriorated on the 4 th day, shifted to your NICU
• Blood c/s Acinetobacter – R to Ampicillin, Amikacin, Gentamicin, carbepenems, & cephalosporins
• What antibiotic to use?
Case 4
• 1.2 kg neonate born at a small hospital in rural area, had respiratory distress treated with hood oxygen and iv fluids given ceftazidime and amikacin.
• Deteriorated on day 3 with shock and bleeding started on meropenem and Piperacillin and vancomycin
• Referred to your NICU on day 4
• Which antibiotic to give
• Culture negative
Case 5
• A 40 day ex 28 week ( CGA 34 week) recovering from NEC on Ceftazidine and Amikacin developed increasing lethargy.
• Which antibiotic?
• When will you consider fungal infection?
• Urine shows fungal hyphae
• CSF – suspicion of fungal invasion
• Ankle Joint swelling noted 2 days later
Key messages
• When not to give antibiotics
• EOS and LOS
• MDR organisms – concept of reserve antibiotics
• Fungal sepsis
• Oral thrush as a pointer to fungal colonization
• Therapy for fungal septicemia, meningitis, arthritis