This guideline sets out an antimicrobial prescribing strategy for insect and spider bites and stings in adults, young people and children aged 72 hours and over, including those that occurred while travelling outside the UK. It aims to limit antibiotic use and reduce antibiotic resistance.
See a 1-page visual summary of the recommendations.
The recommendations in this guideline were developed before the COVID-19 pandemic.
For treating infections associated with other bites and stings, see the NICE webpage on bites and stings. We have also produced NICE guidelines on cellulitis and erysipelas, and antimicrobial stewardship: systems and processes for effective antimicrobial medicine use.
This guideline includes recommendations on:
- assessment and advice
- treating a local inflammatory or allergic skin reaction
- treating an infected insect bite or sting
- referral and seeking specialist advice
Who is it for?
- Healthcare professionals
- People with insect bites and stings, their families and carers
Guideline development process
NICE worked with Public Health England to develop this guidance.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.