The UHL MicroGuide App is your go to guide for all updated antimicrobial information/hospital protocol and is updated regularly. Use it. The link is on iHUB, NCHD App or;
Prior to starting antibiotics
- Take all necessary specimens.
- Where urgent processing is required please inform the Microbiology laboratory 061 482255 during normal working hours or outside of these times contact the microbiology medical scientist on call through the hospital switchboard.
Take account of
- Recent culture reports prior to the use of broad spectrum antibiotics (MRSA,ESBL,VRE,CPE,C-Difficile)
- With successive episodes of Sepsis: Do Not use the same antibiotics repeatedly as resistance may arise
IMPORTANT: Allergy History
- Please take account of the nature of the response. If history is one of an anaphylactic response
- Avoid all Lactams - penicillins, cephalosporins and Carbapenems, Erythromycin or Ciprofloxacin may not be an appropriate choice for all indications.
- Contact Micro/ID to discuss further.
- Duplication of cover - e.g. Piceracillin-tazobactam and Co-amoxiclav have good anaerobic cover; concurrent metronidazole is not indicated unless there is gross faecal contamination - e.g. faecal peritonitis.
After antibiotic therapy has been started
- Review antimicrobials daily/when culture results available.
- Target antimicrobial therapy where a definitive pathogen is identified.
- Beware of results from non-sterile sites as the organism/s isolated may not be the causative organism.
For Cockroft-Gault Equation / Gentamicin and Vancomycin levels and dosing use MICROGUIDE APP.
Gentamicin and Vancomycin level are available within 30 minutes from the lab when requested urgently, otherwise just at 12pm and 4pm.
