The National Institute for Health and Care Excellence (NICE) issued four new antibiotic guidance documents in October, which aim to optimise antibiotic use and reduce antibiotic resistance.
The new guidelines set out antimicrobial prescribing strategies for:
- Treating lower urinary tract infection (cystitis) in children, young people, and adults who do not have a catheter.
- Preventing recurrent urinary tract infections in children, young people, and adults who do not have a catheter.
- Treating acute pyelonephritis in children, young people and adults who do not have a catheter.
- Treating acute prostatitis.
Key antimicrobial governance advice contained in all four documents says that when prescribing antibiotics, take account of severity of symptoms, risk of complications, previous urine culture and susceptibility results, previous antibiotic use which may have led to resistant bacteria and local antimicrobial resistance data.
For prostatitis and acute pyelonephritis specifically, the guidance recommends giving oral antibiotics first-line, if patients can take oral medicines and the severity of their condition does not require intravenous antibiotics, and to review intravenous antibiotics by 48 hours and consider stepping down to oral antibiotics where possible.
In relation to preventing UTI recurrence, the NICE guidance says to ensure any current UTI is treated and to take account of severity and frequency of symptoms, risk of complications and long-term antibiotic use, previous urine culture and susceptibility results, previous antibiotic use, local antimicrobial resistance, and preferences for treatment.
NICE worked with Public Health England to develop the guidance.