About Hospital Guidance

Produced by the Antimicrobial Management Group July 2020

Approved by Acute Drug and Therapeutics Committee

Review Date: July 2023


Summary of significant updates for July 2020 Guidance:

  • Addition of oral switch guidance with preferred and alternate options for empirical IVOST for most scenarios
  • Review of fluoroquinolone recommendations in guidance including link to MHRA statement
  • Reduced IV antibiotic use, polypharmacy and need for therapeutic drug monitoring with increased use of levofloxacin where vancomycin and ciprofloxacin previously recommended
  • Addition of alternative to gentamicin where significant nephrotoxicity concern
  • Further scenarios covered in ENT section
  • Ongoing rationalised use of “4C” antibiotics associated with higher risk of C.difficile infection