Infectious diseases: specific issues
Choosing antibiotics around an allergy label, the endocarditis and bone and joint infection teams and Hospital in the Home, post-exposure prophylaxis in the emergency department (HIV, hepatitis B, tetanus, lyssavirus, meningococcal, varicella, measles), community needlestick injuries, and the Australian notifiable diseases system.
Tier 2Topic overview
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Allergy labels: most penicillin labels are wrong. Risk-stratify (ASCIA 2026 risk categories, or the validated PEN-FAST score) and delabel low-risk patients, and choose a cephalosporin by side chain.
- Complicated infections (endocarditis, prosthetic joint, vertebral osteomyelitis, diabetic foot) do better with a named team, early oral step-down where trials support it, and Hospital in the Home (HITH).
- PEP: HIV within 72 hours for 28 days, hepatitis B immunoglobulin within 72 hours (up to 14 days after sexual exposure), tetanus by wound type and vaccine history, and lyssavirus, meningococcal, varicella and measles prophylaxis when relevant.
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Sources
- Australian National Guidelines for HIV Post-Exposure Prophylaxis (4th ed.): when to prescribe, prescribing, laboratory follow-upAU/NZASHM, endorsed by BBVSS, 2025 (last updated August 2025)
- Australian Immunisation Handbook: Tetanus (guide to tetanus prophylaxis in wound management)AU/NZATAGI, Australian Government Department of Health, Disability and Ageing, page updated 30 September 2026
- National Notifiable Diseases Surveillance System and the National Notifiable Disease ListAU/NZAustralian Centre for Disease Control, page updated 12 May 2026
- ASCIA Guidelines: Adult Penicillin Allergy Management 2026 UpdateAU/NZAustralasian Society of Clinical Immunology and Allergy (ASCIA), 2026
- Therapeutic Guidelines: AntibioticAU/NZTherapeutic Guidelines Limited, current eTG edition (topic version not verified)
- Australian Guidelines for the Prevention and Control of Infection in HealthcareAU/NZNHMRC and Australian Commission on Safety and Quality in Health Care, 2019, maintained on MAGICapp (current online version)
- National Hepatitis B Testing Policy and s100 prescribing updateAU/NZASHM, s100 prescriber accreditation for hepatitis B medicines removed from 1 September 2026
- Li HK et al. Oral versus intravenous antibiotics for bone and joint infection (OVIVA). N Engl J Med 2019;380:425-36New England Journal of Medicine, 2019
- Iversen K et al. Partial oral versus intravenous antibiotic treatment of endocarditis (POET). N Engl J Med 2019;380:415-24New England Journal of Medicine, 2019
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy