48–72 Hour Review and Rationalisation of IV Antimicrobials

Introduction

This guideline is intended for use by prescribers in NHS Ayrshire & Arran (NHS A&A) and aims to lead them through a systematic assessment of prescriptions of intravenous (IV) antimicrobials.

The timely review of IV antimicrobials is a mandatory clinical governance requirement in Scotland. In NHS A&A, effective antimicrobial stewardship (AMS) is essential to reduce the board’s historically long hospital stays, mitigate the risk of C. difficile and line-related bloodstream infections, and ensure financial sustainability.

• 48–72 Hour "Antimicrobial Time-Out"
• Intravenous-to-Oral Switch (IVOS) Criteria
• Empirical Oral Switch Options in NHS A&A
• Review of Gentamicin after 48-72 Hours
• Documentation and Governance