Key messages for all prescribers
Learn and apply all antibiotic use and infection prevention and control recommendations that are relevant to your area of specialisation. Remain aware of local antibiotic resistance patterns in your department, your hospital and in the community.
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Things you can do
1. Learn and apply all antibiotic use and infection prevention and control recommendations that are relevant to your area of specialisation [expert consensus].
2. If you see staff members at the hospital or healthcare setting who breach guidelines or protocols, ask them why they are doing so and provide them with tools to understand what they are doing wrong [69] [expert consensus].
3. Remain aware of local antibiotic resistance patterns in your department, your hospital and in the community [31] [expert consensus].
3. If in doubt before you prescribe an antibiotic, you should [25,26,53,70] [expert consensus]:
- Check local, regional and national epidemiological data;
- Seek guidance and advice from a senior colleague or a member of the antibiotic stewardship team.
4. Ensure that cultures are appropriately taken and send to the microbiology laboratory, before starting antibiotics [31,42,70,71].
5. Only start antibiotic treatment if there is evidence of a bacterial infection, and do not treat colonisation [31,72].
6. Avoid unnecessary antibiotic prophylaxis [31,73].
7. For patients with severe infections, initiate effective antibiotic treatment as soon as possible [31,74].
8. Document the indication of antibiotic treatment, drug choice, dose, route of administration and duration of treatment in the patient chart [31,42,70,71].
9. Regularly participate in training courses and in meetings that support the implementation in the hospital of: a) prudent antibiotic use, b) evidence-based, local antibiotic guidelines, and c) infection prevention and control measures [52,53].
10. Answer the following key questions when reassessing antibiotic therapy after 48-72 hours (or as soon as microbiological results are available) [42,70]:
Does the patient have an infection that will respond to antibiotics?
If yes:
i. Is the patient on the correct antibiotic(s), correct dose, and correct route of administration?
ii. Could an antibiotic with a narrower spectrum be used to treat the infection?
iii. For how long should the patient receive the antibiotic(s)?