Guidelines for antimicrobial therapy

The guidelines should be based on local/regional data on antibiotic resistance. They should include a system for categorising patients with a penicillin allergy and provide information on appropriate treatment options. In addition, they should include guidance on TDM (Therapeutic Drug Monitoring), at least for vancomycin and aminoglycosides.

Various sources can be used as a basis for local guidelines:

• The Swiss Society for Infectious Diseases provides online guidelines for general practice and other specialist areas. 
• Larger hospitals provide access to their guidelines (see list of local guidelines in Switzerland). Some of these include recommendations for penicillin allergies.
• Mobile apps that support the decision-making process regarding treatment
• Swissnoso provides guidelines for perioperative antimicrobial prophylaxis.

Smaller and medium-sized hospitals are advised to use external guidelines for antimicrobial treatment, e.g. from regional tertiary centres or hospital networks, rather than drawing up their own guidelines. 

Ensure that the guidelines are available at the point of prescribing and guide prescribers through the decision-making process. To encourage prescribers to use the guidelines, ideally integrate them into the local IT system, a web application or a smartphone application. 

When developing local guidelines for antimicrobial treatment, prioritise user-friendliness. Use an easy-access format such as a web application. Structure the guidelines so that they can be integrated into the local IT system at a later stage.

Access statistics can provide insight into whether the guidelines are being used.

A procedure for the regular review and updating of local guidelines (recommended at least every three years) should be established within the hospital.

Take into account national recommendations and local trends regarding antibiotic resistance, the availability of antibiotics, etc.

Incorporate a guideline compliance check into the regular prescription audits.