12 February 2019

NICE and Public Health England publish new antibiotic prescribing guidance for patients with suspected pneumonia

These two guidelines set out an antimicrobial prescribing strategy that aims to optimise antibiotic use and reduce antibiotic resistance.

  

In the new drafts, developed with Public Health England, it’s advised that antibiotics should be given to people with community- and hospital-acquired pneumonia within four hours of establishing a diagnosis. Oral antibiotics should be given first-line if the person can take oral medicines, and the severity of their condition does not require intravenous antibiotics.

Choice of antibiotics should be reviewed once results from any microbiological testing are available.

Although it’s advised that shorter courses of antibiotics should be prescribed where appropriate to limit the risk of antimicrobial resistance, it’s important to note that pneumonia can be a life-threatening infection and therefore, an effective course length is important.

This new guidance provides detailed prescribing advice on hospital‑acquired infections that suggest treatment should be reviewed after 5 days and stopping the antibiotic if the person is clinically stable. Regarding community‑acquired infections, new recommendations say that antibiotics should be stopped after 5 days unless the person is not clinically stable.

Paul Chrisp, director of the Centre for Guidelines at NICE, said:

“In patients where there is a suspected case of pneumonia, it’s important that they are given the antibiotics they need as soon as possible. Microbiological testing helps determine what antibiotic will be most effective and helps limit antimicrobial resistance.

"These recommendations will provide healthcare professionals with advice on how to treat pneumonia effectively with antibiotics whilst also making responsible prescribing decisions to promote antimicrobial stewardship and preserve the future effectiveness of antibiotics."

Dr Susan Hopkins, deputy director, National Infection Service, Public Health England, said:

“Rapid treatment of pneumonia is vital, but these new guidelines seek to refine the length of time that patients are using antibiotics in order to tackle resistance. By supporting clinicians to make treatment decisions based on the risk factors that impact the progression of pneumonia, we can encourage appropriate and targeted use of antibiotics.”

"These recommendations will provide healthcare professionals with advice on how to treat pneumonia effectively with antibiotics whilst also making responsible prescribing decisions."

Paul Chrisp, director of the Centre for Guidelines at NICE

"By supporting clinicians to make treatment decisions based on the risk factors that impact the progression of pneumonia, we can encourage appropriate and targeted use of antibiotics.”

Dr Susan Hopkins, deputy director, National Infection Service, Public Health England