Promoting antibiotic stewardship in NHS Lothian
Infectious Diseases and Microbioloy
Antibiotics are a fantastic resource, but we must recognise that unless we use them correctly, their activity against pathogens will reduce. It is our responsibility to use these drugs appropriately.
Inpatient guidelines currently rely heavily on gentamicin – an antibiotic with the potential for serious side effects which requires special care in prescribing. You can get full guidance on this and all aspects of antibiotic prescribing at the Antimicrobial Management Team home page.
The NHS Lothian Vancomycin calculator has changed (January 2021).
This revised calculator and prescribing guidance has been shown, in clinical use in orthopaedics, to get patients to therapeutic levels, when aiming for 15-20 mg/l, more rapidly. The training materials have been revised.
- Choice of trough target levels – choosing target trough level of 15-20 mg/L will result in one band higher being recommended for maintenance dosing
- Infusion rate provided – to reduce the risks seen with administration of vancomycin
- Recommended time of administration for maintenance dose – this has been chosen to reduce overnight administration where possible
- Missed dose guidance – further information provided about what to do if a dose is not given at the prescribed administration time
- Dose adjustment guidance based on levels – further information provided about what to do if the trough levels are not in the required range
Please review the training videos below.
Introduction – Key changes to the new calculator
Getting to therapeutic levels
Review and revise @ 48-72 hours and how to manage a missed dose
Summary and case studies
RIDU: The Role of the Infectious Diseases Unit
An introduction to the Regional Infectious Diseases Unit