2025 Guideline update overview
Antimicrobial prescribing: NHS Forth Valley
Guidelines have been updated considering following:
UK Antimicrobial Resistance 5 year National Action Plan Human Health Targets:
Target 4a: by 2029, we aim to reduce total antibiotic use in human populations by 5% from the 2019 baseline.
Target 4b: by 2029, we aim to achieve 70% of total use of antibiotics from the Access category (new UK category) across the human healthcare system.
The Scottish Antimicrobial Prescribing Group (SAPG), on behalf of NHS Scotland, has produced supplementary targets for primary care prescribing to assist in achieving the National Action Plan targets:
By 2029 - 90% of Amoxicillin and 60% of Doxycycline prescriptions will be for a 5-day course
By 2029 - 85% of Trimethoprim and nitrofurantoin prescriptions in women will be for 3-day course
By 2029 - Less than 3% of all antibiotic prescriptions in primary care will be for co-amoxiclav and ciprofloxacin combined
Summary of main updates/themes to achieve stewardship targets:
- 5 days is as effective as 7 days for majority of common uncomplicated bacterial infection presentations in primary care e.g. URTI, LRTI, SSTI
- Doxycycline in preference to Clarithromycin e.g. URTI, LRTI, SSTI
- Co-trimoxazole in preference to Co-amoxiclav e.g. Pyelonephritis, LRTI
- Cefalexin in preference to Co-amoxiclav e.g. UTI, pyelonephritis
- Doxycycline in preference to Lymecycline e.g. acne, hidradenitis
- Azithromycin in preference to Clarithromycin for Scarlet fever >6month old