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Intravenous antibiotics are more expensive than oral equivalents and some are very expensive they also put patients at risk of IV cannula infections. Oral antibiotics are usually fairly cheap. IM injections are rarely if ever indicated.
Prescriptions for oral antibiotics for in-patients should be reviewed at or before five days. Prescriptions for intravenous antibiotics should be reviewed at or before 48 hours after which the patient should be considered for an oral antibiotic if there is an equivalent available. For uncomplicated urinary tract infections three days treatment is usually sufficient in adult women. Complicated infections require longer treatment.
When initiating therapy with agents marked with , you must seek Microbiology/Infectious Diseases advice.
The restricted antimicrobials may be prescribed without discussion with microbiology if they are being used for an approved indication as specified. Use outside these indications (and any use for some antimicrobials) requires DOCUMENTED approval from one of the medical microbiologists or Infectious Diseases Physician prior to prescribing.
For further information on prescribing antimicrobials at Royal Papworth Hospital please refer to the Microguide
Prescribing in Primary Care and CPFT should follow the Primary Care Prescribing Guidelines and initiate only those treatments recommended as Green (unless on the advice of a microbiologist).
Use in pregnancy
- It is important to ensure adequate treatment of maternal infection in pregnancy as failure to treat may lead to adverse maternal and fetal outcome as a consequence of uncontrolled infection or fever.
- When considering treatment with antibacterial agents during pregnancy, the following factors should be taken into account: the severity of the maternal infection, the presence of fever, the maternal and fetal risks associated with failing to treat the mother adequately, the pharmacokinetic and pharmacodynamic effects (where known) of pregnancy on drug absorption, distribution, metabolism and excretion, and the potential fetotoxicity of the treatments being considered.
- Where possible, antibiotic choice should be informed by culture and sensitivity tests, however if treatment is required urgently or before test results become available, then penicillins or cephalosporins should be considered where clinically appropriate.
- See UKTIS Antibiotic use in Pregnancy for further information.
- Prescribing in Primary Care and CPFT should follow the Primary Care Prescribing Guidelines which includes specific guidance for pregnancy and initiate only those treatments recommended as Green (unless on the advice of a microbiologist).