Protected Antimicrobial Policy

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.

Process for authorising a "Protected Antimicrobial"

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.

  • During weekday working hours (0900 - 1700 hours):
    • To obtain a supply, send a complete Protected Antimicrobial Order Form and indent to pharmacy.
    • The form should be completed by prescribers, stating the indication. Clinical pharmacists can complete the form in conjunction with prescribers.
  • Out-of-hours via on-site coordinator or on-call pharmacists where necessary (including weekends and public holidays):
    • The prescriber should complete the Protected Antimicrobial Order Form and email it to pharmacy. Do not delay treatment if unable to complete the form; obtain an emergency supply and complete the form as soon as possible.
    • A 24 - 72 hour emergency supply can be obtained.


Guideline reviewed: October 2023

Page last updated: November 2023