- Make a diagnosis and assess the severity
- Take the right samples (think blood cultures)
- Manage sepsis see Sepsis 6
- Use the empirical treatment guidelines under Body Systems
- Take an accurate penicillin allergy history see Penicillin allergy
- Document antibiotic plan - indication, severity, antibiotic, route, duration using \antibstart
Antimicrobial prescribing
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These guidelines aim to encourage prudent prescribing of antimicrobials for empirical treatment of infections, improve patient outcomes, and minimise harm including the emergence of antimicrobial resistant strains.
Antimicrobials have been selected on the basis of efficacy, local sensitivity data, safety, and availability.
The Antimicrobial Management Team monitor the use of antimicrobials, associated harms, along with local sensitivity data. We work using behaviour change and quality improvement methodology to constantly try to improve the management infections for patients in NHS Lothian.
Contact us: antimicrobial.stewardship@nhslothian.scot.nhs.uk
The Antimicrobial Management Committee (AMC), a subgroup of the Area Drug and Therapeutics Committee (ADTC), is responsible for the production of these guidelines. These guidelines will be reviewed and updated every two years; this process involves new guideline integration, consultation with relevant specialities and circulation to associated committees.
- Is the diagnosis correct? Review history and available investigations.
- Are antibiotics indicated? If so are orals an option IV-to-Oral Switch Protocol?Is the antibiotic plan correct and documented?
- Are Vancomycin and gentamicin prescribed correctly and levels planned (Gentamicin Step 2. Monitoring)?
Has the patient improved? Review available microbiology results
Document antibiotic plan:
- Confirm indication
- Antibiotic review outcome:
- Stop,
- IV to oral switch,
- Need advice, or
- Continue with next review date clearly documented
- Document with \antibreview