Late Onset (> 5 days) | Right Decisions

Right Decisions
Antimicrobial prescribing: NHS Forth Valley
Paediatric Antibiotic Guidance - Hospital
Respiratory Tract Infections
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Hospital Acquired Pneumonia
Late Onset (> 5 days)

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Micro Organisms

Pseudomonas spp. more likely

First line

Important: Therapy

Piperacillin/tazobactam IV for 5-10 days

Add gentamicin IV if severe Pseudomonal infection

Add vancomycin IV if MRSA suspected or confirmed

Notes:

Consider IV to oral switch when afebrile > 24 hours and clinically improving

Second line: mild intolerance or mild skin reaction

Important: Therapy

Ceftazadime IV for 5-10 days

Add gentamicin IV if severe Pseudomonal infection

Add vancomycin IV if MRSA suspected or confirmed

Notes:

Consider IV to oral switch when afebrile > 24 hours and clinically improving

Anaphylaxis (including severe skin reaction) to penicillin / cephalosporins

Important: Therapy

Vancomycin IV + Ciprofloxacin IV (use higher dosing as per BNFC)