4. Antimicrobial treatment guidelines
(1) Have a local set of evidence-based and relevant guidelines
The guidelines focus on empiric antimicrobial treatment and surgical perioperative prophylaxis. They consider local or regional antimicrobial susceptibility data and provide options for patients with penicillin allergy.
Different sources can be used as a basis for local guidelines:
- The Swiss Society of Infectious Diseases provides online guidelines for general practitioners and other specialists in the outpatient setting.
- Larger hospitals offer access to their guidelines (see list of exemplary local guidelines in Switzerland).
- Mobile apps supporting the decision-making process regarding the therapy (e.g., Firstline, Sanford and others).
- Swissnoso provides guidelines for perioperative antimicrobial prophylaxis.
(2) Ensure local guidelines are user-friendly and used
Guidelines are available to prescribers at the point of care and guide them through the decision-making process. Prescribers use the guidelines. Guidelines are ideally integrated into the local IT system.
If you design local antimicrobial treatment guidelines, focus on usability. Use a readily available format like a web application. Consider structuring them to allow for later integration into electronic patient record applications / your local hospital IT system.
(3) Ensure guidelines are up-to-date
A process to regularly review and update local guidelines (recommended a review interval of 3 to 5 years) is implemented.
(4) Harmonize guidelines
Take into accountConsider national recommendations, local trends in drug resistance, availability of antimicrobials, etc.
Resources and tools
Schweizerische Gesellschaft für Infektiologie: Guidelines
Swissnoso: Guidelines on perioperative antibiotic prophylaxis
Examples for local hospital guidelines (by type of hospital, in alphabetical order):
- Centre hospitalier universtaire vaudois (CHUV): Guide d’antibiothérapie
- Hôpitaux universitaires de Genève (HUGE): link missing
- Inselspital Bern: Richtlinien
- Universitätsspital Basel: Sanford Guide + infektioStandards
- Universitätsspital Zürich (USZ): Bestellung der Richtlinien
- Kantonspital Baden (KSB): Empfehlungen
- Kantonsspital St. Gallen (KSSG): Guidelines
Tips for smaller and medium-sized hospitals
Use of antimicrobial treatment guidelines from regional tertiary centers or hospital networks, rather than producing own guidance.