This policy has been developed to limit the use of specific, valuable antimicrobials which should be reserved for special circumstances (e.g. resistant organisms). These agents are rarely justifiable in community-acquired infection.
The agents are identified by virtue of their broad spectrum of activity and potential toxicity. In most hospital infections, first-line antimicrobial therapy is appropriate, with "Protected Antimicrobials" reserved for complex infections caused by organisms that are resistant to first-line antimicrobial therapy.
The policy lists the protected antimicrobials with their permitted indications and is also available on the NHSGGC Clinical Guideline Platform. These antimicrobials will only be issued from pharmacy on receipt of a completed Protected Antimicrobial Order Form.
If considering escalation of antimicrobial therapy, discuss clinical management (including source control and non-infectious causes of fever) with senior member of the clinical team i.e. registrar or consultant. If a protected agent is being prescribed outwith the permitted indications, the choice must be discussed with a microbiologist or infectious diseases physician. The reason for use and the name of the microbiologist or infectious diseases physician contacted must be recorded on the form and medical notes.
Guideline reviewed: October 2023
Page last updated: November 2023