What is new in this version?

New 13th August 2025

• Updated Asplenia prophylaxis guidance

New 10th July 2025

Updated guidelines - no clinical changes:

• Mass Casualty Events: Infection Considerations: Antimicrobial Prophylaxis
• Meningitis under 1 month
• Meningitis 1 month and over
• Intra-Abdominal Infections (including Peritonitis)
• Preparing and administering line locks
• MRSA decolonisation
• Skin decolonisation
• Pyelonephritis

New 2nd July 2025

• Updated notifiable diseases guidance

New 27th June 2025

• Updated to include Hibiwash the Skin decolonisation pre-procedure and MRSA decolonisation guidelines

New 16th June 2025

• Updated bites guideline

New 16th May 2025

• Updated posaconazole monograph to include information of tablets and oral suspension are not interchangeable 

New 8th May 2025

• Updated Paediatric appendicitis pathway

New 25th March 2025

• Updated Audiometry and intravenous aminoglycosides guideline

New 20th March 2025

• Updated gentamicin drug monograph to include gentamicin monitoring for complicated appendicitis

New 14th March 2025

• Updated tetanus prone wounds guideline 

New 10th March 2025

• Updated Pneumonia, community acquired: mild-moderate
• Updated Pneumonia, community acquired, severe
• Updated Pneumonia, aspiration guideline

New 14th February 2025

• HCID folder updated to include links to HCID sharepoint pages.

New 28th January 2025

• Updated Prevention of secondary meningococcal disease guidance 

New 24th January 2025

• Updated Empirical management of intravascular catheter related infections
• Updated Pathogen specific therapy for intravascular catheter related infections
• Updated fluconazole dose in penetrating chest trauma guideline.

New 20th December 2024

Amphotericin B liposomal (Tillomed/Gilead/AmBisome) nomenclature updated  

New 22nd November 2024

• Link added to Chronic Wet Cough guideline

 

New 20th November 2024

• Updated guideline Soft tissue injury, clean 
• Updated guideline Soft tissue injury, contaminated
• Updated guideline Soft tissue injury, established

 

New 25th September 2024

• New guideline - Ophthalmia Neonatorum (link to this guideline added to acute conjunctivitis guideline)
• New guideline - Paediatric Sinusitis

 

New 19th September 2024

• Updated Osteomyelitis / Septic Arthritis / Pyomyositis / Discitis guideline
• Presentation of co-trimoxazole oral dosing tables standardised across guidelines - no change to clinical content

 

New in version 6.8 (10th July 2024)

• Updated clarithromycin and azithromycin dosing formatting for consistency
• Updated Necrotising fasciitis guideline 
• Updated Mass casualty antimicrobial prophylaxis guideline
• New guideline: Acute Conjunctivitis
• Review dates added to guidelines containing hyperlinks only

 

New in version 6.7 (25th June 2024)

• Pertussis prophylaxis reference updated
• Co-amoxiclav dosing in patients 12 years old and over updated to include liquid option throughout and drug monograph updated.
• Co-amoxiclav dosing updated in the bites (animal/human/insects) guideline
• Vancomycin monograph 
• Updated unlicensed / off-label medicines section

 

New in version 6.6 (6th June 2024)

• Updated Bacterial trancheitis and epiglottitis guideline 
• Added link to Paediatric Haematology and Oncology - Antifungal protocol under haematology oncology: links to guidelines including antifungal protocol
• New Mastoiditis guideline 
• Reverted surgical prophylaxis guidelines in response to cefazolin stock availability

New in version 6.5 (12th April 2024) 

• Updated surgical prophylaxis in response to cefazolin shortage
• Updated pathway diagram in simple appendicitis guideline in response to cefazolin shortage 
• Updated complicated appendicitis guideline in response to cefazolin shortage 
• Updated Teicoplanin monograph

New in version 6.4 (2nd Feb 2024)

• New guidance for measles

New in version 6.3 (14th December 2023)

• Sepsis under 1 month
• Sepsis 1 month and over
• Toxic shock syndrome
• Ambulatory care
• Spinal implant infection
• Meningitis (1 month and over)
• HSV encephalitis
• Penetrating intracranial injury/gunshot (=contaminated neurosurgery)
• Brain abscess
• Meningitis: Post neurosurgical infection
• Colorectal surgery, complicated by perforation/faecal peritonitis
• Penetrating abdominal trauma

New in version 6.2  (4th December 2023)

• Metronidazole treatment doses standardised throughout guide

New in version 6.1 (8th November 2023)

Updated guidance:

• Surgical prophylaxis guidance, including use of cefazolin as first line prophylaxis in specific procedures, change to metronidazole IV dose and change to maximum doses for clindamycin IV and teicoplanin IV
• Suspected appendicitis
• Simple appendicitis (post-operative management)
• Complicated appendicitis (at induction and for post-operative management)
• Open fracture on presentation in Emergency Department
• Enteric fever/Typhoid
• Campylobacter enteritis
• Start Smart Then Focus
• Post-exposure Prophylaxis for Paediatrics

 

New in version 6

Updated guidelines:

• Pertussis prophylaxis
• Haemophilius influenazae type b, prophylaxis
• Clarified comment on gentamicin monograph

New in version 5.8 (27th July 2023)

No change to clinical content - update to layout of main spine of the guidelines

 

New in version 5.7 (25th July 2023)

Updated guideline: e-prescribing of antimicrobials

 

New in version 5.6 (4th July 2023)

No clinical changes - ensuring that links upto date

 

New in version 5.5 (20th June 2023) 

Suspected appendicitis guideline added

Simple appendicitis (post-operative management) guideline added

Complicated appendicitis (intra and post-operative management) guideline added

Lower UTI guideline reviewed - added nitrofurantoin MHRA Drug Safety Update and the use of suspension when unable to swallow tablets

UTI (recurrent) prohylaxis - nitrofurantoin warning updated in line with recent MHRA Drug Safety Update

 

New in version 5.4 (27th April 2023)

Traumatic eye injury - warning added about chloramphenicol eye ointment

Penetrating chest trauma - neonatal dosing removed

Monkeypox renamed to Mpox

 

New in version 5.3 (23rd March 2023)

Oral Amoxicillin doses updated throughout

Pharyngitis/tonsillitis guideline - duration of treatment with penicillin V and amoxicillin updated.

COVID guidelines updated to reflect remdesivir availability

UTI (recurrent) prophylaxis guideline updated to include caution related to long term nitrofurnatoin use.

 

New in version 5.2 (28th February 2023)

New: Audiometry and Intravenous Aminoglycoside guideline 

Updated: Clostridioides difficile infection guideline to include statement re do not use metronidazole liquid when treating C.diff

 

New in version 5.1 (21st December 2022)

New Scarlet Fever guideline

 

New in version 5.0 (19th December 2022 second update) 

Vancomycin drug monograph oral dosing information updated

 

New in version 4.9 (19th December 2022)

New guideline Treatment of COVID-19 in patients hospitalised due to COVID-19

New guideline Treatment of symptomatic hospital-onset COVID-19

COVID-19 folder reviewed and updated

 

New in version 4.8 (22nd November 2022)

Asplenia guideline updated

 

New in version 4.7 (15th November 2022)

Co-amoxiclav drug monograph updated

Amoxicillin drug monograph updated

 

New in version 4.6 August 2022

Haematology oncology: links to guidelines - link updated

Bites section updated and now includes insect bites

Meningitis (under 1 month) updated

Meningitis (over 1 month) updated

NEW gentamicin dosing monograph in Drugs section

 

New in version 4.5 24th June 2022

Updated pathogen specific therapy for intravascular catheter related infections secondary to micafungin to caspofungin switch

New Caspofungin drug monograph

 

New in version 4.4 27th May 2022

Specific treatment of COVID-19 guideline updated to include Baricitinib guidance 

Ciprofloxacin entries - additional warning added to use with caution if history of convulsion 

 

New in version 4.3 20th May 2022

New Monkeypox guidance

 

Version 4.2 May 2022

Updated CPE (Carbapenemase-Producing Enterobacterales) guideline.

 

Version 4.1 March 2022

MRSA decolonisation guideline updated

New Skin decolonisation pre-procedure guideline

 

Version 4 March 2022

Updated guidelines:

• Pneumonia, community acquired: mild-moderate  - duration of clarithromycin and amoxicllin updated
• Tonsillectomy prophylaxis guidelines

 

Version 3.9 February 2022

Font updated throughout to internet compatable font.

Updated guidelines:

• Pneumonia, community acquired: mild-moderate
• Pneumonia, community acquired: severe
• Pneumonia, aspiration
• Lymphadenitis, mild-moderate
• Otitis media
• Pharyngitis/tonsillitis

Removed the guideline Following adeniodectomy/Tonsillectomy - if post-op and antibacterials are clinically indicated

 

Version 3.8 December 2021

Specific treatment of COVID-19 folder updated.

 

Version 3.7 December 2021

No change to clinical content - formating issue in the table within the Specific Treatment of COVID-19 section 

Version 3.69 December 2021

No change to clinical content - formating issue in the table within the Specific Treatment of COVID-19 section 

Version 3.68 December 2021

No change to clinical content - formating issue in the table within the Specific Treatment of COVID-19 section 

Version 3.67 December 2021

No change to clinical content - formating issue in the table within the Specific Treatment of COVID-19 section 

Version 3.66 November 2021

Neurosciences surgical prophylaxis section updated and new guidance for Spina Bifida repair.

Clostridioides difficile infection guideline updated.

Specific Treatment of COVID-19 section updated to include Ronapreve^® (casirivimab + imdevimab)

 

Version 3.65 October 2021

New guideline: Specific Treatment of COVID-19, replaces Management of COVID-19 guideline.

 

Version 3.64 August 2021

Prevention of secondary meningococcal disease updated to include link to MHRA fluroquinolone patient information leaflet. Now hyperlinked to adult guide.

Perforated Appendicitis - addition of statement about gentamicin levels

Updated guidelines:

• Soft tissue injury, established infection
• Infected eczema, bacterial, mild-moderate
• infected eczema, bacterial, severe 
• Infected eczema, herpeticum

 

 

Version 3.63 April 2021

New guideline: Preparing and administering antimicrobial line locks

Updated guidelines:

Empirical management of intravascular catheter related infections

Pathogen specific therapy for intravascular catheter related infections

Management of patients with tetanus-prone wounds

Updated useful contact numbers section 

Updated notifiable diseases section

 

Version 3.62 November 2020

Removed duplicate HCID section

Added icons to the guidelines

 

Version 3.61 November 2020

Kawasaki disease guideline updated - link included

Management of Infected CNS shunts updated

Lymphadenitis (mild-moderate) guideline updated

Lymphadenitis (severe) guideline updated

Epiglottitis guideline updated

Campylobacter enteritis guideline updated

Pharyngitis and Tonsilitis guideline updated

Bacterial tracheitis guideline updated

Following adenoidectomy tonsillectomy guideline updated

Otitis media guideline updated

Paed malaria updated

Addition of link to microbiology intranet page

 

 

Version 3.6 August 2020

Malaria guideline in the process of being updated.

 

Version 3.55 July 2020

Aspiration pneumonia guideline - dosing tables added

New Guideline: Impetigo

Toxic shock guideline updated

Necrotising fascitis guideline updated

Wound infection guideline renamed as Surgical Site infection guideline and updated

Soft tissue injury, contaminated guideline updated

 

Version 3.54

Mild - moderate CAP guideline updated

Severe CAP guideline updated

Aspiration pneumonia guideline updated

Lower UTI guideline updated

Pyelonephritis updated

Vancomycin IV -  Intravenous Vancomycin Paediatric Dosing Guideline (if eGFR 51ml/min/1.73m² or more) section updated

COVID-19 section updated

 

Version 3.53 

Post-exposure Prophylaxis for Paediatrics  - no changes to drug recomendations, updated to reflect use of generic products

COVID-19: Links to adult microguide for the guidelines in this folder

 

Version 3.52

COVID-19 guidelines added

 

Version 3.51 (January 2020)

Technical change - no clinical changes

 

Version 3.5 (January 2020)

Technical change - no clinical changes

 

Version 3.4 (January 2020) 

New guidelines:

Spinal infection

Penetrating intracranial inujry/gunshot

Brain abscess

Post-operative meningitis

 

Updated guidelines:

Treatment:

Enteric fever/typhoid

Cellulitis (mild-moderate)

Cellulitis (severe)

Urinary tract

Intra-abdominal infections

Colorectal surgery

Penetrating abdominal trauma

 

Prophylaxis:

Head and neck surgery (+/- oral lesions)

Craniofacial surgery - both sections

Elective hand surgery in children 

 

Version 3.3 (January 2020)

Bone and joint infection updated with latest guidance

Sepsis and meningitis folder changed to sepsis and meningitis section updated

Removed sepsis identification and management as all information now detailled on EPR

Open fracture guidance updated

Mass casualty guidance updated

Addendum - CPE Infection control guidelines were updated in this version

 

Version 3.2 (September 2019)

Appendicitis pathways and guideline

Gastro-intestinal surgery prophylaxis

 

Version 3.1 (September 2019)

Lower UTI - Added alternative to cefalexin during period of shortage for patient needing liquid formulation 

Recurrent UTI - cefalexin removed as alternative option

Bites - updated

 

Version 3 (August 2019) - typo corrected from version 2.8

Neonatal guidelines removed - See interim neonatal guidelines available from the neonatal unit

 

Version 2.8 (June 2019)

• Lower UTI guidance updated
• Pyelonephritis guidance updated
• Blood cultures: action to take
• Sepsis or meningitis: Amoxicillin indicated changed to less than 1 month only
• Vancomycin dosing guidance updated

 

Version 2.7 (June 2019)

Updated hyperlink to Febrile neutropenia guidelines.

Updated 'Prevention of secondary meningococcal disease' section

 

Version 2.6 (February 2019)

• Change to IV vancomycin dosing guidance
• New Intravascular cathether management guidance
• Micturating cystourethrogram (MCUG) guidance updated
• Urinary tract section - Lower UTI  guidance updated
• Cleft lip and palate guidance updated
• Periorbital guidance updated
• New Infected eczema guidance (Bacterial mild-moderate, Bacterial severe and Herpeticum)
• Otitis media updated to state "Consider no antibacterial treatment for 72 hours"

 

 

 Version 2.1 (May 2018)

New items:

• Neonatal antimicrobial guidelines 
• Paediatric vancomycin dosing guideline 
• Paediatric teicoplanin dosing guideline 

 

 

Version 2 (February 2018)

PEP - Post-exposure Prophylaxis for Paediatrics added to Paediatric MicroGuide 

 

 

This is version 9 (v 1.9) of the OUHFT Paediatric antimicrobial guideline on the MicroGuide Portal.

New this version (July 2017):

• Updated C Diff section
• Updated MRSA decolonisation section

For any comments, enquiries or suggestions for improvement, please contact AMT@ouh.nhs.uk