Technical Guidelines for Integrated Disease Surveillance ... - PHRplus

Reassess the patient after the first 30 ml per kg, and then every 1 to 2 hours. If hydration status is notimproving, give the IV drip more rapidly. Also give ORS (about 5 ml per kg per hour) as soon as the patient can drink. This is usually after 3–4hours for infants and after 1–2 hours for patients older than one year. Reassess the patient after six hours (for infants) or three hours (for one year and older). Classify dehydration.Then choose the appropriate plan (Plan A, Plan B, Plan C) to continue treatment. Give antibiotics recommended for treatment of severely dehydrated cholera patients. (See the scheduleabove.) Give patients information about home care before they leave the health facility. If the patient vomits while taking ORS, wait 10 minutes and then continue giving fluids moreslowly. Continue breastfeeding of infants and young children. Also give home-based fluids as follows: rice-water, mashed kenkey,mashed tuo-zafi, light soup without pepper, akasa, coconut juice and fruit juice.Return for treatment if the patient develops any of the following: increased number of watery stools eating or drinking poorly marked thirst repeated vomiting fever blood in the stool.2. Give an appropriate oral antibiotic for outbreaks of bloody diarrhoea due to Shigelladysentariae type 1.Source: Adapted WHO Guidelines for the control of epidemics due to S. dysentariae type 1. WHO Geneva. 1995WEIGHTADULT TABLET80 mgtrimethoprim +400 mgsulphamethoxazoleCOTRIMOXAZOLE {First Line}(trimethoprim + sulphamethoxazole)Give two times daily for 5 daysPEDIATRICTABLET20 mgtrimethoprim +100 mgsulphamethoxazoleSYRUP40 mgtrimethoprim +200 mgsulphamethoxazoleper 5 mlNALIDIXIC ACID{Second Line}Give four times dailyfor 5 daysTABLET250 mgCIPROFLOXACINGive two times dailyfor 5 daysTABLET250 mgChildren’sdose3 - 5 kg 1/4 2 5.0 ml 1/4 1/46 - 9 kg 1/2 1/2 1/210 - 14 kg 1 3 7.5 ml 1 115 - 19 kg 1 3 7.5 ml 1 120 - 29 kg 1 6 15 ml 2 2Adult doseTABLET160 mg TMP +800 mg SMXTABLET250 mgTABLET250 mg2 tablets 4 tablets 4 tablets194Technical Guidelines for Integrated Disease Surveillance and Response in Ghana