How do I pick which antibiotic to use?
Overview
Antibiotic choices vary between hospital and community settings, and by region. They also change over time.
Primary Resource
Guidelines are produced by local microbiologists and can be seen on the GMMMG website by clicking here.
🩺 Clinical Scenarios
⚠️ Allergy to Options
If the patient is allergic to all guideline options, contact the microbiologist on call. Ring RAEI switchboard on 01942 244 000.
Treatment Failure
If antibiotics from the guideline aren’t working, send a microbiology sample (e.g., sputum, swab, urinalysis) to guide treatment. Consider asking your supervisor or calling the microbiologist.
🖥️ Prescribing Protocol & Codes
Broad-Spectrum Checks
Issuing an acute prescription for broad-spectrum antibiotics triggers a protocol checking for a Read code for the condition.
System Logic
| Trigger | Action | Outcome |
|---|---|---|
| Prescribing Broad-Spectrum | System checks for Read code | Prompt to add code if missing |
| Clicking ‘No’ on Read Code | User directed to code browser | Access formulary codes |
| Adding to Repeat | User adds diagnosis | Assign ‘Antibiotic prophylaxis indicated’ |
Code Browser Workflow
A formulary has been created duplicating the Salford recommended list of codes under their sub-headings.
- Click the Formulary tab
- Select ‘antibiotic prescribing indication national SNOMED + Read codes’
- Filter codes by sub-headings (e.g., Urinary Tract Infections)
- Select appropriate code to assign condition
Repeat Prescriptions
Antibiotics added to repeat prescriptions must be assigned the diagnosis ‘Antibiotic prophylaxis indicated’ (code 413555000). This excludes the patient from reports.