Empirical selection of an antibiotic in non-outbreak Vibrio cholerae infections in Nepal at the sub-health and health posts Patient Entry Available ATBs TMP-SMX Tetracycline Chloramphenicol Benzyl Penicillin Sub-health & health posts Questions Is patient a child, an adult or a pregnant woman? If available at the post, Erythromycin Adult Child Pregnant Woman TMP-SMX Tetracycline or TMP-SMP or Chloramphenicol TMP-SMP or Tetracycline if pregnancy  3 months Action Threshold Severity of dehydration Alert threshold V. cholereae Resistance Prevalence TMP-SMX 20% Chloramphenicol 20% Tetracycline 10% Child Adult Pregnant Woman Doxycline or Ciprofloxacin (both contraindicated in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL INFECTIONS AS:10-26-02

Empirical selection of an antibiotic in non-outbreak Vibrio cholerae infections in Nepal at the district level Patient Entry Available ATBs Amoxicillin ,TMP-SMX, Tetracycline, Chloramphenicol, Benzyl Penicillin, Cloxacillin, Erythromycin, Ciprofloxacin, Gentamicin, Metronidazole, Rifampicin, Streptomycin, Ethambutol, Sulfaacetamide, Doxycycline, Nitrofurantoin District Level Questions Is patient a child, an adult or a pregnant woman? Erythromycin Adult Child Pregnant Woman TMP-SMX Tetracycline or TMP-SMP or Chloramphenicol TMP-SMP or Tetracycline if pregnancy  3 months Action Threshold Severity of dehydration Alert threshold V. cholereae Resistance Prevalence TMP-SMX 20% Chloramphenicol 20% Tetracycline 10% Child Adult Pregnant Woman Doxycline or Ciprofloxacin (both contraindicated in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL INFECTIONS AS:10-26-02

Empirical selection of an antibiotic in non-outbreak Vibrio cholerae infections in Nepal at the national level Patient Entry Available ATBs Amoxicillin ,TMP-SMX, Tetracycline, Chloramphenicol, Benzyl Penicillin, Cloxacillin, Erythromycin, Ciprofloxacin, Gentamicin, Metronidazole, Rifampicin, Streptomycin, Ethambutol, Sulfaacetamide, Doxycycline, Nitrofurantoin, Cefotaxime National Level Questions Is patient a child, an adult or a pregnant woman? Erythromycin Adult Child Pregnant Woman TMP-SMX Tetracycline or TMP-SMP or Chloramphenicol TMP-SMP or Tetracycline if pregnancy  3 months Action Threshold Severity of dehydration Alert threshold V. cholereae Resistance Prevalence TMP-SMX 20% Chloramphenicol 20% Tetracycline 10% Child Adult Pregnant Woman Doxycline or Ciprofloxacin (both contraindicated in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL INFECTIONS AS:10-26-02

Empirical selection of an antibiotic in non-outbreak N Empirical selection of an antibiotic in non-outbreak N. gonorrheae infections in Nepal at the sub-health and health posts Patient Entry Available ATBs TMP-SMX Tetracycline Chloramphenicol Benzyl Penicillin Sub-health & health posts Questions Is patient a child, an adult or a pregnant woman? If available at the post, Azithromycin Adult Child Pregnant Woman Benzyl Penicillin Benzyl Penicillin Benzyl Penicillin Action Threshold Disease Specific Alert threshold N. gonorrheae Resistance Prevalence PPNG  5% Child Adult Pregnant Woman Ceftriaxone ( IM) or Cefixime (PO); Norfloxacin, Ciprofloxacin and Ofloxacin WHO PRESCRIBING GUIDE FOR BACTERIAL INFECTIONS AS:10-26-02

Empirical selection of an antibiotic in non-outbreak N Empirical selection of an antibiotic in non-outbreak N. gonorrheae infections in Nepal at the district level Patient Entry Available ATBs Amoxicillin ,TMP-SMX, Tetracycline, Chloramphenicol, Benzyl Penicillin, Cloxacillin, Erythromycin, Ciprofloxacin, Gentamicin, Metronidazole, Rifampicin, Streptomycin, Ethambutol, Sulfaacetamide, Doxycycline, Nitrofurantoin District Level Questions Is patient a child, an adult or a pregnant woman? If available at the post, Azithromycin Adult Child Pregnant Woman Benzyl Penicillin TMP-SMX Tetracycline, TMP-SMX or Chloramphenicol TMP-SMX or Tetracycline if pregnancy  3 months Action Threshold Disease Specific Alert threshold N. gonorrheae Resistance Prevalence PPNG  5% Child Adult Pregnant Woman Ceftriaxone ( IM) or Cefixime (PO); norfloxacin, ciprofloxacin and ofloxacin WHO PRESCRIBING GUIDE FOR BACTERIAL INFECTIONS AS:10-26-02

Empirical selection of an antibiotic in non-outbreak N Empirical selection of an antibiotic in non-outbreak N. gonorrheae infections in Nepal at the national level Patient Entry Available ATBs Amoxicillin ,TMP-SMX, Tetracycline, Chloramphenicol, Benzyl Penicillin, Cloxacillin, Erythromycin, Ciprofloxacin, Gentamicin, Metronidazole, Rifampicin, Streptomycin, Ethambutol, Sulfaacetamide, Doxycycline, Nitrofurantoin, Cefotaxime National Level Questions Is patient a child, an adult or a pregnant woman? If available at the post, Azithromycin Adult Child Pregnant Woman TMP-SMX Tetracycline or TMP-SMP or Chloramphenicol TMP-SMP or Tetracycline if pregnancy  3 months Action Threshold Disease Specific Alert threshold N. gonorrheae Resistance Prevalence PPNG  5% Child Adult Pregnant Woman Ceftriaxone ( IM) or Cefixime (PO); norfloxacin, ciprofloxacin and ofloxacin WHO PRESCRIBING GUIDE FOR BACTERIAL INFECTIONS AS:10-26-02

Empirical selection of an antibiotic in non-outbreak Shigella sp Empirical selection of an antibiotic in non-outbreak Shigella sp. infections in Nepal at the sub-health and health posts Patient Entry Available ATBs TMP-SMX Tetracycline Chloramphenicol Benzyl Penicillin Sub-health & health posts Questions Is patient a child, an adult or a pregnant woman? If available at the post, Erythromycin Adult Child Pregnant Woman TMP-SMX Tetracycline or TMP-SMP or Chloramphenicol TMP-SMP or Tetracycline if pregnancy  3 months Action Threshold Severity of dehydration Alert threshold Shigella sp. Resistance Prevalence TMP-SMX 20% Chloramphenicol 20% Tetracycline 10% Child Adult Pregnant Woman Doxycline or Ciprofloxacin (both contraindicated in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL INFECTIONS AS:10-26-02

Empirical selection of an antibiotic in non-outbreak Shigella sp Empirical selection of an antibiotic in non-outbreak Shigella sp. infections in Nepal at the district level Patient Entry Available ATBs Amoxicillin ,TMP-SMX, Tetracycline, Chloramphenicol, Benzyl Penicillin, Cloxacillin, Erythromycin, Ciprofloxacin, Gentamicin, Metronidazole, Rifampicin, Streptomycin, Ethambutol, Sulfaacetamide, Doxycycline, Nitrofurantoin District Level Questions Is patient a child, an adult or a pregnant woman? If available at the post, Erythromycin Adult Child Pregnant Woman TMP-SMX Tetracycline or TMP-SMP or Chloramphenicol TMP-SMP or Tetracycline if pregnancy  3 months Action Threshold Severity of dehydration Alert threshold Shigella sp. Resistance Prevalence TMP-SMX 20% Chloramphenicol 20% Tetracycline 10% Child Adult Pregnant Woman Doxycline or Ciprofloxacin (both contraindicated in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL INFECTIONS AS:10-26-02

Empirical selection of an antibiotic in non-outbreak Shigella sp Empirical selection of an antibiotic in non-outbreak Shigella sp. infections in Nepal at the national level Patient Entry Available ATBs Amoxicillin ,TMP-SMX, Tetracycline, Chloramphenicol, Benzyl Penicillin, Cloxacillin, Erythromycin, Ciprofloxacin, Gentamicin, Metronidazole, Rifampicin, Streptomycin, Ethambutol, Sulfaacetamide, Doxycycline, Nitrofurantoin, Cefotaxime National Level Questions Is patient a child, an adult or a pregnant woman? If available at the post, Erythromycin Adult Child Pregnant Woman TMP-SMX Tetracycline or TMP-SMP or Chloramphenicol TMP-SMP or Tetracycline if pregnancy  3 months Action Threshold Severity of dehydration Alert threshold Shigella sp. Resistance Prevalence TMP-SMX 20% Chloramphenicol 20% Tetracycline 10% Child Adult Pregnant Woman Doxycline or Ciprofloxacin (both contraindicated in pregnancy) WHO PRESCRIBING GUIDE FOR BACTERIAL INFECTIONS AS:10-26-02