抗生素处方的忠告Advice to COCP users when prescribing antibiotics Jan 2011PPT.ppt

Advice to COCP users when prescribing antibioticsJan 2011 New advice When prescribing antibiotics there is no need to give “extra precaution” advice (condoms or abstain for length of course and 7 days afterwards) to COCP users. Something you always thought or does this feel uncomfortable? Exceptions! Enzyme inducing drugs – rifampicin, rifambutin (consistently shown to decrease ethinyl estradiol levels) If antibiotics cause vomiting and diarrhoea Old theory Antibiotics temporarily reduce colonic bacteria Decrease in colonic bacteria decreases enterohepatic recycling of ethinyl estradiol Estradiol part of COCP that is the anovulant Ovulation...pregnancy There is no evidence for any of this! Who’s making these rules? FSRH has previously acknowledged the lack of evidence for this advice. Admits that it was being “cautious.” WHO Medical Eligibility Criteria and U.S. Medical Eligibility Criteria have both now adopted this recommendation... So FSRH have joined in aswell Are you going to change your advice? 9 replies 2 will change advice, 3 won’t 4 are just a bit cross “Who made a mistake? How did they do that? What advice are they currently offering? Why should I pay more attention to that? If the FRSH thingummy follows advice they have no reason to think is correct, why should I follow them? As they apparently demand.”