HOW TO ACCESS MICROBIOLOGY ADVICE (Antimicrobial)

Microbiology Advice

Consultant Microbiologists are available to provide clinical advice on the diagnosis and management of infection. They work as part of a team of infection specialists who deal with different aspects of infection management.

Consider whether your query is best put to the Microbiologist, or an alternative infection specialist eg:

• Infectious Diseases (where an ID Consultant review of the patient is indicated, or in cases with travel related infection. NOT for antibiotic advice.)
• OPAT
• Pharmacist
• Infection Control
• Health Protection

Antimicrobial prescribing guidance

• Check current and previous Microbiology results on SciStore to guide antimicrobial choice.
• Positive blood cultures will be phoned to the relevant clinical area by one of the Microbiology team, with Gram results viewable on SciStore at the same time.
• If no culture results are available, please check NHS Highland TAM (Treatments and Medicines) webpage/app. This includes advice on empirical antibiotics in primary and secondary care, IV-to-oral switch therapy in the absence of positive cultures, and surgical prophylaxis guidelines.

Accessing Microbiology clinical advice

If your question has not been answered from the resources above, the question should be escalated through usual routes of clinical supervision up to and including the responsible consultant.

If the question cannot be answered within the clinical team, the following routes are available to access advice from the Duty Microbiologist:

Mon to Fri, 09:00 to 17:00: Ext 4206
Mon to Fri, 17:00 to 09:00 & Sat/Sun: contact On Call Microbiology Consultant via Raigmore Switchboard.

When calling for microbiology advice, please have up-to-date information about your patient to hand, including the following:

• Date and reason for admission
• Current clinical problem and microbiology question (with overview of relevant microbiology results and sensitivities)
• Relevant past medical/surgical history, travel & other exposure history
• Overview of recent observations, blood results, radiology results etc
• Most recent consultant review and plan
• History of antibiotics given during/prior to this admission
• Details of known antibiotic allergies

When calling out-of-hours, junior medical staff should consider whether the query can be resolved through discussion with senior members of their team. If the query cannot be resolved, the senior clinician should decide whether the case should be discussed urgently with the On Call Microbiologist or whether non-urgent cases can be discussed the following morning.