Professional Documents
Culture Documents
Policy no: P 45
Category Clinical
2. Aim 3
4. Distribution 3
5. Responsibilities 4
6. Combinations 5
7. Length of treatment 5
8. Availability 5
9 Penicillin allergy 5
12 Vaccinations 9
13 Methicillin Resistant Staphylococcus Aureus (MRSA) 10
14 References 13
• Allergy history
• Renal and hepatic functions
• Whether immunocompromised or not
• Ability to tolerate drugs by mouth
• Severity of illness
• Ethnic origin
• Age
• Other medications
• If female, whether they are pregnant, breast-feeding or on oral
contraceptives.
• The known or likely causal organism and it antibacterial sensitivity
2. Aims
The aims of the policy is to:
4. Distribution
4.1 This policy is applicable to all BEHMHT adult wards or units and
should be read by any healthcare professionals likely to be
involved in antibiotic prescribing, administering or dispensing
process.
4.2 A copy will be held in all clinical areas and may also be accessed
via the Trust intranet.
5.1 Prescriber
5.2 Nurse
5.3 Pharmacist
7. Length of treatment
Specific advice regarding length of therapy is available for example from
the British National Formulary (B.N.F), and if necessary from your local
microbiology department for certain conditions. In the absence of such
advice, treatment should be discontinued after five days if a satisfactory
clinical response has been obtained.
8. Availability of antibiotics
It is expected that inpatients of the Mental Health Trust will only be
prescribed broad-spectrum antibiotics. All other antibiotics can only be
prescribed if specified by NMH or BCF microbiology.
Patients needing IV antibiotics are likely to be transferred to acute
general wards as opposed to being treated on mental health wards.
Day Hospital and outpatients should see their General Practitioner for
treatment of community-acquired infections.
9. Penicillin Allergy
Please follow general ‘Medicines Management Policy’ guidance as for all
allergies. See below:
Pneumonia
Basic principles
Management of pneumonia depends on whether it is acquired outside the hospital, i.e. community
acquired pneumonia or inside the hospital, i.e. nosocomial or hospital acquired pneumonia.
Treatment with antibiotics should be for at least one week provided response is satisfactory and the
patient should have been afebrile for at least 48 hours at the time of discontinuing treatment. Treatment
should be by the oral route. Intravenous therapy may be necessary when oral administration is
impossible, e.g. vomiting or in severe pneumonia until 24 hours after the fever has settled. Initial
12. Vaccinations
Influenza Annual vaccination for all persons aged 65 years and over as well as younger
people in established “high-risk” groups (those living in long-stay residential
and nursing homes or other long-stay facilities, persons with chronic heart
disease, chronic respiratory disease including asthma, chronic renal disease,
diabetes mellitus and immuno-suppression due to disease or treatment).
Pneumococcal Once only, for people 65+
The treatment protocol below should be given for 5 full days. It may
only be repeated once for a further 5 days. Subsequent treatment of
patients who persist to be MRSA positive must be discussed with the
ICL.
2. Chlorhexidine 4%
3. Wound care
Follow Up Screening
The patient should be screened for MRSA 48 hours after stopping the
topical treatment, by taking swabs or specimens from the following
sites:
• Nose
• Perineum or groin
• Sputum if productive
• Catheter specimen of urine if patient is catheterised
• Any breaks in the skin including pressure sores or leg ulcers
Please see Trust policy IC03 (MRSA Policy March 2009), available on the
Intranet, for further information on the treatment of MRSA.