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Summary NICE - Bacterial infections and their 1st line antibiotic treatment

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A detailed, quick-reference table consisting of all of the NICE-accredited bacterial infections and their first-line antibiotic treatment.

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BACTERIAL INFECTIONS

Antibacterials, use for prophylaxis

Early-onset neonatal infection Benzylpenicillin or clindamycin
Caesarean section Cefuroxime
Hysterectomy Cefuroxime + metronidazole
Cardiac pacemaker insertion Cefuroxime or flucloxacillin + gentamicin
Joint replacement (incl. knee and hip) Cefuroxime or flucloxacillin or gentamicin (IV)
Transrectal prostate biopsy Ciprofloxacin + metronidazole + gentamicin
Meningococcal meningitis Ciprofloxacin or rifampicin
Pertussis Clarithromycin
Animal and human bites Co-amoxiclav or doxycycline + metronidazole
Open fractures Co-amoxiclav or doxycycline + metronidazole
Diphtheria in non-immune Pts Erythromycin
Operations on stomach or oesophagus Gentamicin or cefuroxime or co-amoxiclav (IV)
Termination of pregnancy Metronidazole
Invasive group A streptococcal infections Phenoxymethylpenicillin
Rheumatic disease Phenoxymethylpenicillin or sulfadiazine
Haemophilus influenzae type B disease Rifampicin

Blood infections

Meningococcal septicaemia Benzylpenicillin
Septicaemia Piperacillin with tazobactam or cefuroxime
Septicaemia related to vascular catheter Vancomycin

Cardiovascular system infections

Endocarditis (initial ‘blind’ therapy) Amoxicillin
Endocarditis caused by enterococci Amoxicillin + gentamicin
Endocarditis (caused by Haemophilus,
Actinobacillus, Cardiobacterium, Eikenella and Amoxicillin + low dose gentamicin
Kingella species (‘HACEK’ micro-organisms))
Endocarditis caused by streptococci Benzylpenicillin +/- gentamicin

Central nervous system infections

Benzylpenicillin (if suspected)
Meningitis (initial empirical therapy) Cefotaxime (if aetiology unknown)
Cefotaxime + amoxicillin (if > 50 years old)
Meningitis caused by meningococci Benzylpenicillin or cefotaxime
Meningitis caused by pneumococci Cefotaxime
Meningitis caused by Haemophilus influenzae Cefotaxime
Meningitis caused by Listeria Amoxicillin + gentamicin

Ear infections

Otitis externa Flucloxacillin
Otitis media Amoxicillin

Eye infections

Conjunctivitis (purulent) Chloramphenicol

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January 16, 2022
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