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Empirical Antibiotic Guidelines for the Management of Common Infections in Adult Inpatients

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Empirical Antibiotic Guidelines for the Management of Common Infections in Adult Inpatients EMPIRICAL ANTIBIOTIC GUIDELINES FOR THE MANAGEMENT OF COMMON INFECTIONS IN ADULT INPATIENTS Useful contacts: Consultant Clinical Microbiologist via switchboard Antimicrobial Pharmacist Bleep 294 Medicines Information Ext 2092 Topic/ Heading: Empirical antibiotic guideline for the management of common infections in adult inpatients Lead Clinician for Guideline: Dr. S N Patel, Consultant Microbiologist & Nicola Robinson, Senior Pharmacist Antimicrobials/ ICU Discipline: Medicines Management / Microbiology / Pharmacy Date of Guideline: September 2017 Version: 4.0 Approved By: Drugs & Therapeutics Committee and Antibiotic Stewardship Group Date: 26/7/16 Audit Date: Monthly and as indicated in annual antibiotic audit plan Guideline Review Date: September 2018 Review Completed By: Dr. S N Patel Consultant Microbiologist, Emma Guthrie Senior Pharmacist, Agnieszka Fryer Senior Pharmacist. Rationale for Development: To support prudent use of antimicrobials across the Trust Aims and Objectives: To ensure appropriate antibiotic treatment of common infections in adult inpatients Method of Guideline Development: In accordance with Trust policy Equality Impact Assessment: n/a Roles & Responsibilities: refer to Antimicrobial Prescribing policy in PIMS Guideline: Empirical antibiotic guidelines for the management of common infections in adult inpatients Evidence Base: See reference list Consultation: 2013 Blue Book with changes approved by relevant clinicians Implementation: Available via PIMS Monitoring: Antibiotic Stewardship Group annual audit plan Training Plan: Incorporated into induction training of new doctors and into regular training of medical, pharmacy and nursing staff. Outcome Measures and Audit Criteria: Regular antibiotic audits in medicine and surgery and antibiotic ward rounds Assessment of Competence to Carry Out the Procedure n/a Author: Dr Sneha Patel, Consultant Microbiologist & Emma Guthrie, Senior Pharmacist and Agnieszka Fryer, Senior Pharmacist Empirical antibiotic guidelines for the management of common infections in adult inpatients Version 4.2 Review Date: September 2018 Page 1 of 57 CONTENTS 1 INTRODUCTION .................................................................................................................................................. 3 2 RECOMMENDATIONS FOR THE PRUDENT USE OF ANTIMICROBIALS .................................................................. 4 2.1 PRINCIPLES OF GOOD ANTIBIOTIC PRESCRIBING ............................................................................................................ 4 2.2 REDUCING/PREVENTING C.DIFFICILE INFECTIONS ......................................................................................................... 5 2.3 IV TO ORAL SWITCH GUIDANCE ............................................................................................................................... 5 2.4 CLINICAL ADVICE ................................................................................................................................................... 5 2.5 RESTRICTED ANTIBIOTICS ......................................................................................................................................... 5 2.6 PENICILLIN ALLERGY OR NOT? ................................................................................................................................. 6 2.7 SPECIMENS .......................................................................................................................................................... 6 3 BONE AND JOINT INFECTIONS ............................................................................................................................ 7 4 CARDIOVASCULAR SYSTEM INFECTIONS ............................................................................................................ 8 4.1 BACTERIAL ENDOCARDITIS – EMPIRICAL THERAPY ........................................................................................................ 8 4.2 BACTERIAL ENDOCARDITIS – ORGANISM KNOWN......................................................................................................... 9 5 CENTRAL NERVOUS SYSTEM INFECTIONS ......................................................................................................... 11 5.1 BACTERIAL MENINGITIS ........................................................................................................................................ 11 5.2 OTHER CNS INFECTIONS....................................................................................................................................... 12 5.3 PROPHYLAXIS FOR CONTACTS OF HAEMOPHILUS AND MENINGOCOCCUS MENINGITIS ...................................................... 13 6 GASTROINTESTINAL INFECTIONS (INCLUDING CLOSTRIDIUM DIFFICILE INFECTION) ......................................... 14 6.1 GASTROINTESTINAL INFECTIONS ............................................................................................................................. 14 6.2 CLOSTRIDIUM DIFFICILE INFECTION (CDI) ................................................................................................................. 16 7 RESPIRATORY SYSTEM INFECTIONS .................................................................................................................. 18 8 SEPSIS............................................................................................................................................................... 22 9 SKIN AND SOFT TISSUE INFECTIONS ................................................................................................................. 23 10 UROGENITAL INFECTIONS ................................................................................................................................ 24 APPENDIX A – THERAPEUTIC DRUG MONITORING (TDM) ......................................................................................... 27 A.1 ONCE DAILY GENTAMICIN PROTOCOL ..................................................................................................................... 28 A.2 LOW DOSE GENTAMICIN FOR BACTERIAL ENDOCARDITIS ............................................................................................. 30 A.3 ROLES AND RESPONSIBILITIES FOR GENTAMICIN PRESCRIBING AND MONITORING ............................................................ 31 A.4 AMIKACIN .......................................................................................................................................................... 32 A.5 VANCOMYCIN ..................................................................................................................................................... 33 A.6 TEICOPLANIN ...................................................................................................................................................... 35 APPENDIX B – SURGICAL ANTIBIOTIC PROPHYLAXIS ................................................................................................. 36 APPENDIX C – SPLENECTOMY PATIENTS: PREVENTION OF INFECTION ...................................................................... 42 APPENDIX D – NEUTROPENIA: MANAGEMENT OF NEUTROPENIC FEVER ................................................................. 44 APPENDIX E – DIABETIC FOOT INFECTION ................................................................................................................. 47 APPENDIX F – SPECTRUM OF ACTIVITY OF ANTIBIOTICS ........................................................................................... 49 APPENDIX G – DOSE ADJUSTMENT IN RENAL IMPAIRMENT ..................................................................................... 52 Author: Dr Sneha Patel, Consultant Microbiologist & Emma Guthrie, Senior Pharmacist and Agnieszka Fryer, Senior Pharmacist Empirical antibiotic guidelines for the management of common infections in adult inpatients Version 4.0 Review Date: August 2018 Page 2 of 57 1 Introduction All NHS bodies are legally responsible for having antimicrobial prescribing policies in place as summarised in the following publications from the Department of Health (DH): The Health and Social Care Act, Code of Practice for health and adult social care on the prevention and control of infections and related guidance. 2008 (Updated 2010.); The Health Act 2006 Code of Practice for the Prevention and Control of Healthcare Associated Infections. The DH issued specific recommendations in the supporting document, Saving Lives: reducing infection, delivering clean and safe care: Antimicrobial Prescribing, including regular audit of antimicrobial prescribing to determine compliance with local guidelines. Further guidance provided an outline of evidence based antimicrobial stewardship in the secondary care setting: Antimicrobial Stewardship ‘Start Smart - then Focus’ DH November 2011(updated 2015). The purpose of empirical antibiotic guidelines is to: Guide prescribers on the use of antibiotics in an evidence-based manner. Reduce the incidence of Healthcare Associated Infections (HCAIs) Reduce the emergence of antimicrobial resistance Minimise adverse effects Make the Trust compliant with the Health and Social Care Act. This guideline is not all encompassing. It aims to include the common infections seen at Kingston Hospital. This guideline is adapted from the Blue Book Guideline for the Management of Common Medical Emergencies and for the use of Antimicrobial Drugs 2013 edition and revised. Every attempt has
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