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No vegetations more than 5 mm diameter on echocardiogram. • No cardiovascular risk factors such as heart failure, aortic insufficiency or conduction abnormalities. • Clinical response within 7 days. Temperature should return to normal, patient should feel well and appetite should return. B. 1 mg/ml) Penicillin G 20 mU per day given in equally divided doses every 4 hours by IV bolus injection for 28 days PLUS gentamicin 80 mg IV twice daily for 28 days. Page 50 Definitive treatment of Enterococcal endocarditis Enterococcus faecalis and Enterococcus faecium are more resistant to penicillin than the viridans streptococci.

The usual course of acute otitis media is spontaneous resolution for the majority of patients within 1 – 2 days. The routine use of antibiotics for this condition is based largely on the fear of complications, if antibiotics are not used. Because Streptococcus pneumoniae is the most common cause of acute otitis media and the least likely to resolve on its own, therapy must be effective against this organism. Strains of Streptococcus pneumoniae throughout South Africa have shown rapid changes in their resistance patterns, and hence the recommendations in this guideline are based on surveillance data on antimic-robial susceptibilities, especially for penicillin.

G. history of previous PID, multiple partners, young, known gonococcal or chlamydia infections) - antibiotic is probably indicated. 1st generation cephalosporin eg. cefazolin 1 - 2 g IV. Page 40 • • Elective caesarian section Prophylactic antibiotics are not indicated. Insertion of IUCD Prophylactic antibiotics are not indicated. 12. UROLOGICAL SURGERY • Prostatectomy Prophylaxis only in high risk patients viz. uraemia, diabetes, neurological bladder, large residual volume, cardiac disease or previous UTI.

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