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New edition of children's BNF published

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An updated edition of British National Formulary for Children has been published.

The latest version includes new guidance on the treatment of community-acquired pneumonia, prevention of secondary cases of Haemophilus influenzae type b disease, the prescribing of controlled drugs by independent prescribers and oral anticoagulants.

Guidance on the management of community-acquired pneumonia has been updated to reflect updated British Thoracic Society guidelines.

Oral amoxicillin is the antibacterial of choice in children over one month of age who require treatment. A macrolide can be added if there is no response.

Intravenous antibacterial treatment should be reserved for children with septicaemia, complicated pneumonia, or if oral administration is not possible.

In addition, guidance on the prevention of secondary cases Hib disease has been updated to take into account the recommendations of the British Infection Society.

Antibacterial prophylaxis should be given to all household contacts of an index case with confirmed or suspected invasive Hib disease if there is a vulnerable individual in the household.

Antibacterial prophylaxis should also be given to the index case if they are under 10 years of age or if they are in contact with vulnerable household contact, such as the immunocompromised, those with asplenia, or children under 10 years of age.

Rifampicin remains the prophylaxis of choice, but ceftriaxone is recommended when rifampicin cannot be used. Advice is also provided on immunisation of the index case against Hib.

Meanwhile, guidance on the controlled drugs that may be prescribed by independent prescribershas been updated in line with legislation that came into force in April. Nurse independent prescribers and pharmacist independent prescribers are able to prescribe, administer and give directions for the administration of Schedule 2, 3, 4, and 5 controlled drugs.

Lastly, guidance for the use and monitoring of warfarin has also been updated  to reflect the recommendations of the British Committee for Standards in Haematology. In the absence of specific guidelines on the management of warfarin in children, updated advice for adults is included on INR targets and the management of haemorrhage.

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