PROPHYLACTIC

MEASURES
SNEHA GANESH
2ND YR MBBS
WHAT IS PROPHYLAXIS ?

• Prophylaxis is defined as a process of guarding against the development of a

specific disease by a treatment or action that affects pathogenesis
• In medicine, the term prophylactic is used to describe procedures and treatment that
prevent something from happening.
• The prevention of disease is often easier, faster, less expensive, and less painful than
treating the disease.
• Generally speaking, prophylaxis doesn't just mean preventing disease. It can also
mean preventing a disease from getting worse or preventing over-treatment.
TYPES OF PROPHYLAXIS

• Primary Prophylaxis
• Secondary Prophylaxis
• Tertiary Prophylaxis
• Quaternary Prophylaxis
PRIMARY PROPHYLAXIS

• This means preventing or increasing resistance to a disease that you don't have. This may include
routine medical checkups and vaccinations
• Pap smears, screening colonoscopies, and mammograms
are often done when there are no signs of disease
• Once a disease is diagnosed, screening is no longer considered primary prophylaxis.
 SECONDARY PROPHYLAXIS

• Measures are taken to prevent a medical problem or injury from happening again
• This could be changing your work environment to prevent re-injury or taking a statin
to prevent another heart attack.
TERTIARY PROPHYLAXIS

• These are steps to help recover from a chronic, ongoing disease or an injury
with long-lasting effects.
• Examples include stroke rehabilitation programs or disease management
programs for heart failure.
QUATERNARY PROPHYLAXIS

• This is the idea that excessive medical treatment can sometimes cause harm and should be
prevented.
• If patients will not benefit from further medical treatment, then they should not be subjected
to it.
• For example, if a patient does not respond to the first round of chemotherapy, there is no
reason to do a second round.
PROPHYLACTIC ANTIBIOTICS

• The term "prophylactic antibiotics" refers to antibiotics that are given to prevent infection rather
than treat it
• Prophylactic antibiotics are avoided whenever possible in health care.
• The overuse of antibiotics has led to antibiotic resistance and provides no benefit to the patient.
• Your physician may choose to prescribe prophylactic antibiotics because the potential benefit
outweighs the risk of harm
• In some cases, preventive antibiotics can reduce the risk of infection for patients at high risk.
 HOSPITAL ACQUIRED INFECTIONS (HAIS)

• major safety concern for both health care providers and the patients.
• Considering morbidity, mortality, increased length of stay and the cost,
efforts should be made to make the hospitals as safe as possible by
preventing such infections.
GENERAL MEASURES OF INFECTION CONTROL

• Isolation Assess the need for isolation. Screen all intensive care unit (ICU)
patients
• Identify the type of isolation needed.
• Observe hand hygiene Hands are the most common vehicle for transmission of
organisms and “hand hygiene” is the single most effective means of preventing
the horizontal transmission of infections among hospital patients and health care
personnel.
• Follow standard precautions Standard precautions include prudent preventive
measures to be used at all times, regardless of a patient's infection status.
• Gloves sterile gloves should be worn after hand hygiene procedure while touching
mucous membrane and non-intact skin and performing sterile procedures.
• Gown wear a gown to prevent soiling of clothing and skin during procedures that are
likely to generate splashes of blood, body fluids, secretions or excretions
• Mask, eye protection/face shield Wear a mask and adequate eye protection or a face
shield to protect mucous membranes of the eyes, nose and mouth during procedures
and patient care activities that are likely to generate splashes/sprays of blood and
body fluids
• Shoe and head coverings They are not required for routine care
FOLLOW TRANSMISSION-BASED PRECAUTIONS

• Patient-care equipment -Used patient-care equipment soiled with blood,

body fluids, secretions, or excretions should be handled carefully to
prevent skin and mucous membrane exposures, contamination of clothing
and transfer of microorganisms to HCWs, other patients or the
environment
 AIRBORNE PRECAUTIONS

• Isolate with negative-pressure ventilation

• Respiratory protection must be employed when entering the
isolation room
• Use the disposable N-95 respirator mask
 CONTACT PRECAUTIONS

• Isolation is required
• Non-critical patient-care equipment should preferably be of
single use. If unavoidable, then clean and disinfect them
adequately before using to another patient
• Limit transport of the patient
DROPLET PRECAUTIONS

• Caused byinfluenza virus, Bordetella pertussis, Hemophilus

influenzae ,, Neisseria meningitidis, Mycoplasma pneumoniae,
coronavirus, Group A Streptococcus, adenovirus and rhinovirus.
• Isolation is required
• Respiratory protection must be employed when entering the isolation
room or within 6-10 ft of the patient. Use the disposable N-95
respirator mask.
• Limit transport of the patient
USE SPECIFIC STRATEGIES FOCUSED ON PREVENTION OF
SPECIFIC NOSOCOMIAL INFECTIONS

• In addition to the standard and transmission-based precautions,

there are several strategies focused on prevention of specific
nosocomial infections in critically ill patients. They are
• ventilator-associated pneumonia (VAP)
• catheter-related bloodstream infection (CRBSI)
• urinary tract infection (UTI)
 STRATEGIES TO REDUCE VAP
• Avoid intubation whenever possible
• Consider noninvasive ventilation whenever possible
• Prefer oral intubations to nasal unless contraindicated
• Daily oral care with chlorhexidine solution of strength 0.12%
• Avoid re intubation whenever possible
• Routine change of ventilator circuits is not required
• Monitor endotracheal tube cuff pressure (keep it >20 cm H2 O) to avoid air leaks around the cuff,
which can allow entry of bacterial pathogens into the lower respiratory tract
• Prefer endotracheal tubes with a subglottic suction port to prevent pooling of secretions around the
cuff leading to microaspiration
• Closed endotracheal suction systems may be better than the open suction
• Periodically drain and discard any condensate that collects in the tubing of a mechanical ventilator
STRATEGIES TO REDUCE CRBSI
 STRATEGIES TO REDUCE UTI

• Insert catheters only for appropriate indications

• Follow aseptic insertion of the urinary catheter
• At all times the urinary catheter should be placed and taped above the
thigh and the urinary bag should hang below the level of the bladder
• The urinary bag should never have floor contact
• Changing indwelling catheters or drainage bags at fixed intervals is not
recommended
• Remove the catheter when it is no longer needed
GUIDELINES FOR INFECTION PREVENTION IN BURNS
PATIENTS
• The development of infection depends on the presence of three conditions
• a source of organisms; a mode of transmission; and the susceptibility of the
patient.
• To provide early identification of organisms colonizing the wound
• To monitor the effectiveness of current wound treatment
• To detect any cross-colonizations, which occur quickly so that further
transmission can be prevented
• Routine surveillance wound cultures should be obtained when the patient is
admitted and at least weekly until the wound is closed.
THANK YOU!!!