Antibiotics should be given to people with community- and hospital-acquired pneumonia within four hours of establishing a diagnosis, the National Institute for Health and Care Excellence and Public Health England say in draft antibiotic prescribing guidance for patients with suspected pneumonia.
Oral antibiotics should be given first line, if the patient can take oral medicines and the severity of their condition does not warrant intravenous antibiotics. The initial choice of antibiotics should then be reviewed once results from any microbiological testing are available.
Although shorter courses of antibiotics should be prescribed where appropriate to limit the wider development of antimicrobial resistance, it is important to give an effective course length because pneumonia is a life-threatening condition, the guidance says.
Antibiotic treatment of hospital acquired infections should be reviewed after five days and stopped if the patient is clinically stable, and stopped after five days for community-acquired infection unless the person is not clinically stable.
Paul Chrisp, director of the Centre for Guidelines at NICE, said: “In patients where there is a suspected case of pneumonia, it’s important that they are given the antibiotics they need as soon as possible. Microbiological testing helps determine what antibiotic will be most effective and helps limit antimicrobial resistance.
“These recommendations will provide healthcare professionals with advice on how to treat pneumonia effectively with antibiotics whilst also making responsible prescribing decisions to promote antimicrobial stewardship and preserve the future effectiveness of antibiotics.”
Dr Susan Hopkins, deputy director, National Infection Service, Public Health England, said: “Rapid treatment of pneumonia is vital, but these new guidelines seek to refine the length of time that patients are using antibiotics in order to tackle resistance. By supporting clinicians to make treatment decisions based on the risk factors that impact the progression of pneumonia, we can encourage appropriate and targeted use of antibiotics.”