Guide to antibiotic use and antimicrobial policy for adults

If specific advice is required then please contact the Consultant Microbiologists:

• Dr Rao - extension 2749 (bleep 207)
• Dr Pang - extension 4986 ( bleep 207)

If requiring advice out of “normal working hours” please contact the on-call Microbiology Consultant via the switchboard.

If requiring antibiotic assays (e.g for Teicoplanin, Vancomycin, Tobramycin, Amikacin) send a separate blood to microbiology. Delays may be caused if the request is on a blood sample, that also requests tests that are performed in blood sciences.

Gentamicin assays are the only assays performed in Blood sciences.

For flowchart and the request form for OAPT read: Outpatient Parenteral Antimicrobial Therapy Referral workflow for inpatient.

As from 11 January 2022, the microbiology department will be reporting antimicrobial susceptibility results as per the updated guidance released by the European Committee on Antimicrobial Susceptibility Testing (EUCAST). 

The new interpretations are categorised and defined into three susceptibility categories:

1. S – susceptible, standard dosing regimen: a microorganism is categorised as susceptible, standard dosing regimen, when there is a high likelihood of therapeutic success using a standard dosing regimen of the agent.
2. I (high dose) – susceptible, increased exposure: a microorganism is categorised as susceptible, increased exposure* when there is a high likelihood of therapeutic success because exposure to the agent is increased by adjusting the dosing regimen or by its concentration at the site of infection.
3. R – resistant: a microorganism is categorised as resistant when there is a high likelihood of therapeutic failure even when there is increased exposure.

*Exposure is a function of how the mode of administration, dose, dosing interval, infusion time (as well as distribution and excretion of the antimicrobial agent) will influence the infecting organism at the site of infection.

Please refer to the antimicrobial policy for further information. Alternatively, contact the microbiology department or senior clinical pharmacist if further guidance is required.