Action 2:
Key points:

Use Therapeutic Guidelines: Antibiotic1
when prescribing antibiotics

If local guidelines are required, they should
take into account recommendations in
Therapeutic Guidelines: Antibiotic1 and
also reflect local antimicrobial
susceptibilities
Therapeutic Guidelines: Antibiotic1 is prepared by an
expert group of experienced clinicians, and represents the
best available evidence and opinion regarding treatment
and prophylaxis for infections in Australia.

Consult the best available evidence and
specialist clinicians for guidance on the
management of infections not covered by
guidelines
Prescribers should use Therapeutic Guidelines: Antibiotic1
when prescribing antibiotics. The latest version should be
readily accessible to clinicians wherever antibiotics are
being prescribed.

Ensure the latest version of guidelines are
readily accessible wherever antibiotics are
prescribed
Use Therapeutic
Guidelines: Antibiotic1
Prescribing guidelines for antibiotics are a fundamental
component of an antimicrobial stewardship (AMS)
program because they guide the appropriate use of
antibiotics.
Health care organisations should have antibiotic prescribing guidelines that take into consideration the advice in the
latest version of Therapeutic Guidelines: Antibiotic,1 reflect common infections relevant to the patient population, the
local antimicrobial susceptibilities, and the procedures being performed. They should specify recommended
agent(s), dose, route and duration of antibiotic treatment. Guidance for switching from intravenous to oral therapy
should also be available. Guidelines should be regularly reviewed and updated in consultation with key clinicians to
ensure best practice is upheld. An important part of the review process is ensuring that only the latest versions of
guidelines are available for use.2
For conditions not covered by Therapeutic Guidelines: Antibiotic,1 organisations should refer to the best available
evidence, seek expert guidance from infectious disease (ID) specialists, microbiologists and pharmacists, and
consult relevant professional associations and colleges.
A lack of awareness about local and national resources that support antibiotic prescribing has been identified as a
barrier to appropriate prescribing.3 Organisations can promote adherence to prescribing guidelines by ensuring that
the latest version of guidelines are readily accessible such as via the organisation’s intranet, and by informing
prescribers of their availability.4 Embedding guidelines into clinical decision support systems and electronic
prescribing systems increases guideline uptake and concordance, and provides further opportunity to guide
appropriate prescribing of antibiotics at the point of care.5, 6 Auditing antibiotic prescribing and antibiotic usage and
providing feedback about patient outcomes markedly improves prescribing in accordance with guidelines.2, 7
Guidelines can also form the basis for educating prescribers on accepted practice for antibiotic prescribing in the
organisation.2
More information about Therapeutic Guidelines: Antibiotic1
The aim of Therapeutic Guidelines: Antibiotic1 is to assist clinicians by providing clear, practical, authoritative and
succinct therapeutic information, to ensure optimal patient management.
Feedback from users of Therapeutic Guidelines: Antibiotic1 is essential to its development, and all comments
received during the lifetime of the guideline are considered at the next update.
The strength of the evidence for any given treatment is also fundamental to the development of the
recommendations in prescribing guidelines. Therapeutic Guidelines: Antibiotic1 includes detailed information about
the process for development of the guidelines, including the way in which ‘evidence rich’ and ‘evidence poor’ areas
are dealt with.
Therapeutic Guidelines: Antibiotic1 can be accessed at www.tg.org.au/. The next edition of Therapeutic Guidelines:
Antibiotic (version 15) will be published in November 2014.
The Antimicrobial Stewardship (AMS) Clinical Care Standard.
The Antimicrobial Stewardship (AMS) Clinical Care Standard aims to ensure that a patient with a bacterial
infection receives optimal treatment with antibiotics. It provides advice to clinicians, consumers and health
services on key components of care related to antibiotic therapy. The AMS Clinical Care Standard is due
for publication late 2014. For more information, visit www.safetyandquality.gov.au/ccs
References and further reading
1. Antibiotic Expert Group. Therapeutic Guidelines: Antibiotic. Version 14. Melbourne: Therapeutic Guidelines Ltd;
2010. Note: The next edition of Therapeutic Guidelines: Antibiotic (version 15) will be published in November
2014.
2. Duguid M, Cruickshank M (editors). Antibiotic Stewardship in Australian Hospitals. Sydney: Australian
Commission on Safety and Quality in Health Care, 2011.
3. Marwick C, Nathwani D. Improving antibiotic prescribing through knowledge and skills. Journal of Antibiotic
Chemotherapy 2007;59:819-820.
4. Drew R, White R, MacDougall C, Hermsen E, Owens R, Jr, Society of Infectious Diseases Pharmacists. Insights
from the Society of Infectious Diseases Pharmacists on antibiotic stewardship guidelines from the Infectious
Diseases Society of America and the Society of Epidemiology of America. Pharmacotherapy 2009;29(5):593607.
5. Hunt D, Haynes R, Hanna S, Smith K. Effects of computer-based clinical decision support systems on physician
performance and patient outcomes: a systematic review. Journal of the American Medical Association
1998;280(15):1339-46.
6. Shiffman R, Liaw Y, Brandt C, Corb G. Computer-based guideline implementation systems: a systematic review
of functionality and effectiveness. Journal of the American Informatics Association 1999;6(2):104-14.
7. Dellit T, Owens R, McGowan J, Gerding D, Weinstein R, Burke J, Huskins W, Paterson D, Fishman N,
Carpenter C, Brennan P, Billeter M, Hooten T. Infectious Diseases Society of America (ISDA) and the Society
for Healthcare Epidemiology of America (SHEA) guidelines for developing an institutional program to enhance
antibiotic stewardship. Clinical Infectious Diseases 2007;44(2):159-177.
Date of publication: 24 October 2014.
This document is intended for use by health professionals. It has been created from information contained in Antimicrobial Stewardship in
Australian Hospitals 2011 and reviewed by clinical experts. Reasonable care has been taken to ensure this information is accurate at the date of
creation. This fact sheet is intended to be used in its original version and can be downloaded from the Australian Commission on Safety and Quality
in Health Care web page www.safetyandquality.gov.au
“No action today, no cure tomorrow” is adopted from the WHO World Health Day 2011.
2