What is new in this version?

New 10th July 2026

• Link added to UKHSA prevention of secondary Haemophilus influenzae type b (Hib) disease guidance

New 9th June 2026

• Updated penetrating chest trauma guideline
• Updated Vancomycin drug monograph 
• Guidelines reviewed and no updates needed: 
  • Colorectal surgery complicated by perforation/faecal peritonitis
  • Simple appendicitis
  • Suspected appendicitis
  • Penetrating abdominal trauma
  • Infected eczema (herpeticum)
  • Lower UTI guideline

New 22nd April 2026

• New Pinna cellulitis / perichondritis guideline

New 17th April 2026

• Updated Asplenia guideline
• Updated Rabies Post Exposure Treatment section

New 26th March 2026

• Updated UTI (recurrent) prophylaxis guideline
• Updated Surgical Site Infection guideline
• Updated Lymphadenitis (mild-moderate) guideline - no clinical changes
• Updated Lymphadenitis (severe) guideline - no clinical changes

New 24th March 2026

• Updated Clostridioides difficile guideline

New 16th March 2026

• Several guidelines updated to replace clarithromycin with azithromycin

New 3rd March 2026

• Updated Respiratory Virus Testing guidance
• Updated Measles guidance

New 12th February 2026

• Updated Measles guideline
• Updated oral co-amoxiclav dosing table throughout guidelines

New 5th February 2026

• Fluoroquinolone messaging updated throughout to include statement regarding MHRA Drug Safety Updates

New 23rd January 2026

• Updated pneumonia, community acquired (mild to moderate) guideline
• Updated pneumonia, community acquired (severe) guideline
• Updated pneumonia, aspiration (mild to moderate) guideline
• New section Healthcare-associated pneumonia (HAP) guideline
• Updated Intravascular catheter, pathogen specific therapy for intravascular catheter related infections

New 31st December 2025

• Updated Ambulatory care guideline

New 30th December 2025

• Updated Treatment of COVID-19 in patients hospitalised due to COVID-19 guideline

New 19th December 2025

• New influenza folder with 5 subfolders

New 15th October 2025

• Updated nomenclature for amphotericin B liposomal throughout guidelines

New 14th October 2025

• Updated General principles document in Peri-Procedure Antibiotic folder to include Metronidazole redosing advice during prolonged procedures

New 24th September 2025

• Updated Cellulitis (severe) guideline
• Updated Acute osteoarticular infection, including septic arthritis and acute osteomyelitis guideline

New 23rd September 2025

• Updated Ophthalmia neonatorum guideline 

New 17th September 2025

• Link added to staff winter vaccination share point page

New 16th September 2025

• New statement regarding position on the use of fluoroquinolones in paediatric patients

New 5th September 2025

• Rifampicin shortage statement added

New 13th August 2025

• Updated Asplenia prophylaxis guidance

New 10th July 2025

Updated guidelines - no clinical changes:

• Mass Casualty Events: Infection Considerations: Antimicrobial Prophylaxis
• Meningitis under 1 month
• Meningitis 1 month and over
• Intra-Abdominal Infections (including Peritonitis)
• Preparing and administering line locks
• MRSA decolonisation
• Skin decolonisation
• Pyelonephritis

New 2nd July 2025

• Updated notifiable diseases guidance

New 27th June 2025

• Updated to include Hibiwash the Skin decolonisation pre-procedure and MRSA decolonisation guidelines

New 16th June 2025

• Updated bites guideline

New 16th May 2025

• Updated posaconazole monograph to include information of tablets and oral suspension are not interchangeable 

New 8th May 2025

• Updated Paediatric appendicitis pathway

New 25th March 2025

• Updated Audiometry and intravenous aminoglycosides guideline

New 20th March 2025

• Updated gentamicin drug monograph to include gentamicin monitoring for complicated appendicitis

New 14th March 2025

• Updated tetanus prone wounds guideline 

New 10th March 2025

• Updated Pneumonia, community acquired: mild-moderate
• Updated Pneumonia, community acquired, severe
• Updated Pneumonia, aspiration guideline

New 14th February 2025

• HCID folder updated to include links to HCID sharepoint pages.

New 28th January 2025

• Updated Prevention of secondary meningococcal disease guidance 

New 24th January 2025

• Updated Empirical management of intravascular catheter related infections
• Updated Pathogen specific therapy for intravascular catheter related infections
• Updated fluconazole dose in penetrating chest trauma guideline.

New 20th December 2024

Amphotericin B liposomal (Tillomed/Gilead/AmBisome) nomenclature updated  

New 22nd November 2024

• Link added to Chronic Wet Cough guideline

New 20th November 2024

• Updated guideline Soft tissue injury, clean 
• Updated guideline Soft tissue injury, contaminated
• Updated guideline Soft tissue injury, established

New 25th September 2024

• New guideline - Ophthalmia Neonatorum (link to this guideline added to acute conjunctivitis guideline)
• New guideline - Paediatric Sinusitis

New 19th September 2024

• Updated Osteomyelitis / Septic Arthritis / Pyomyositis / Discitis guideline
• Presentation of co-trimoxazole oral dosing tables standardised across guidelines - no change to clinical content

New in version 6.8 (10th July 2024)

• Updated clarithromycin and azithromycin dosing formatting for consistency
• Updated Necrotising fasciitis guideline 
• Updated Mass casualty antimicrobial prophylaxis guideline
• New guideline: Acute Conjunctivitis
• Review dates added to guidelines containing hyperlinks only

New in version 6.7 (25th June 2024)

• Pertussis prophylaxis reference updated
• Co-amoxiclav dosing in patients 12 years old and over updated to include liquid option throughout and drug monograph updated.
• Co-amoxiclav dosing updated in the bites (animal/human/insects) guideline
• Vancomycin monograph 
• Updated unlicensed / off-label medicines section

New in version 6.6 (6th June 2024)

• Updated Bacterial tracheitis and epiglottitis guideline 
• Added link to Paediatric Haematology and Oncology - Antifungal protocol under haematology oncology: links to guidelines including antifungal protocol
• New Mastoiditis guideline 
• Reverted surgical prophylaxis guidelines in response to cefazolin stock availability

New in version 6.5 (12th April 2024) 

• Updated surgical prophylaxis in response to cefazolin shortage
• Updated pathway diagram in simple appendicitis guideline in response to cefazolin shortage 
• Updated complicated appendicitis guideline in response to cefazolin shortage 
• Updated Teicoplanin monograph

New in version 6.4 (2nd Feb 2024)

• New guidance for measles

New in version 6.3 (14th December 2023)

• Sepsis under 1 month
• Sepsis 1 month and over
• Toxic shock syndrome
• Ambulatory care
• Spinal implant infection
• Meningitis (1 month and over)
• HSV encephalitis
• Penetrating intracranial injury/gunshot (=contaminated neurosurgery)
• Brain abscess
• Meningitis: Post neurosurgical infection
• Colorectal surgery, complicated by perforation/faecal peritonitis
• Penetrating abdominal trauma

New in version 6.2  (4th December 2023)

• Metronidazole treatment doses standardised throughout guide

New in version 6.1 (8th November 2023)

Updated guidance:

• Surgical prophylaxis guidance, including use of cefazolin as first line prophylaxis in specific procedures, change to metronidazole IV dose and change to maximum doses for clindamycin IV and teicoplanin IV
• Suspected appendicitis
• Simple appendicitis (post-operative management)
• Complicated appendicitis (at induction and for post-operative management)
• Open fracture on presentation in Emergency Department
• Enteric fever/Typhoid
• Campylobacter enteritis
• Start Smart Then Focus
• Post-exposure Prophylaxis for Paediatrics

New in version 6

• Pertussis prophylaxis
• Haemophilus influenzae type b, prophylaxis
• Clarified comment on gentamicin monograph

New in version 5.8 (27th July 2023)

• No change to clinical content - update to layout of main spine of the guidelines

New in version 5.7 (25th July 2023)

• Updated guideline: e-prescribing of antimicrobials

New in version 5.6 (4th July 2023)

• No clinical changes - ensuring that links up to date

New in version 5.5 (20th June 2023) 

• Suspected appendicitis guideline added
• Simple appendicitis (post-operative management) guideline added
• Complicated appendicitis (intra and post-operative management) guideline added
• Lower UTI guideline reviewed - added nitrofurantoin MHRA Drug Safety Update and the use of suspension when unable to swallow tablets
• UTI (recurrent) prophylaxis - nitrofurantoin warning updated in line with recent MHRA Drug Safety Update

New in version 5.4 (27th April 2023)

• Traumatic eye injury - warning added about chloramphenicol eye ointment
• Penetrating chest trauma - neonatal dosing removed
• Monkeypox renamed to Mpox

New in version 5.3 (23rd March 2023)

• Oral Amoxicillin doses updated throughout
• Pharyngitis/tonsillitis guideline - duration of treatment with penicillin V and amoxicillin updated.
• COVID guidelines updated to reflect remdesivir availability
• UTI (recurrent) prophylaxis guideline updated to include caution related to long term nitrofurantoin use.

New in version 5.2 (28th February 2023)

• New: Audiometry and Intravenous Aminoglycoside guideline 
• Updated: Clostridioides difficile infection guideline to include statement re do not use metronidazole liquid when treating C.diff

New in version 5.1 (21st December 2022)

• New Scarlet Fever guideline

New in version 5.0 (19th December 2022 second update) 

• Vancomycin drug monograph oral dosing information updated

New in version 4.9 (19th December 2022)

• New guideline Treatment of COVID-19 in patients hospitalised due to COVID-19
• New guideline Treatment of symptomatic hospital-onset COVID-19
• COVID-19 folder reviewed and updated

New in version 4.8 (22nd November 2022)

• Asplenia guideline updated

New in version 4.7 (15th November 2022)

• Co-amoxiclav drug monograph updated
• Amoxicillin drug monograph updated

New in version 4.6 August 2022

• Haematology oncology: links to guidelines - link updated
• Bites section updated and now includes insect bites
• Meningitis (under 1 month) updated
• Meningitis (over 1 month) updated
• NEW gentamicin dosing monograph in Drugs section

New in version 4.5 24th June 2022

• Updated pathogen specific therapy for intravascular catheter related infections secondary to micafungin to caspofungin switch
• New Caspofungin drug monograph

New in version 4.4 27th May 2022

• Specific treatment of COVID-19 guideline updated to include Baricitinib guidance 
• Ciprofloxacin entries - additional warning added to use with caution if history of convulsion 

New in version 4.3 20th May 2022

• New Monkeypox guidance

Version 4.2 May 2022

• Updated CPE (Carbapenemase-Producing Enterobacterales) guideline.

Version 4.1 March 2022

• MRSA decolonisation guideline updated
• New Skin decolonisation pre-procedure guideline

Version 4 March 2022

• Updated guidelines:
  • Pneumonia, community acquired: mild-moderate  - duration of clarithromycin and amoxicllin updated
  • Tonsillectomy prophylaxis guidelines

Version 3.9 February 2022

• Font updated throughout to internet compatible font.
• Updated guidelines:
  • Pneumonia, community acquired: mild-moderate
  • Pneumonia, community acquired: severe
  • Pneumonia, aspiration
  • Lymphadenitis, mild-moderate
  • Otitis media
  • Pharyngitis/tonsillitis
• Removed the guideline Following adeniodectomy/Tonsillectomy - if post-op and antibacterials are clinically indicated

Version 3.8 December 2021

• Specific treatment of COVID-19 folder updated.

Version 3.7 December 2021

• No change to clinical content - formatting issue in the table within the Specific Treatment of COVID-19 section 

Version 3.69 December 2021

• No change to clinical content - formatting issue in the table within the Specific Treatment of COVID-19 section 

Version 3.68 December 2021

• No change to clinical content - formatting issue in the table within the Specific Treatment of COVID-19 section 

Version 3.67 December 2021

• No change to clinical content - formatting issue in the table within the Specific Treatment of COVID-19 section 

Version 3.66 November 2021

• Neurosciences surgical prophylaxis section updated and new guidance for Spina Bifida repair.
• Clostridioides difficile infection guideline updated.
• Specific Treatment of COVID-19 section updated to include Ronapreve^® (casirivimab + imdevimab)

Version 3.65 October 2021

• New guideline: Specific Treatment of COVID-19, replaces Management of COVID-19 guideline.

Version 3.64 August 2021

• Prevention of secondary meningococcal disease updated to include link to MHRA fluroquinolone patient information leaflet. Now hyperlinked to adult guide.
• Perforated Appendicitis - addition of statement about gentamicin levels
• Updated guidelines:
  • Soft tissue injury, established infection
  • Infected eczema, bacterial, mild-moderate
  • infected eczema, bacterial, severe 
  • Infected eczema, herpeticum

Version 3.63 April 2021

• New guideline: Preparing and administering antimicrobial line locks
• Updated guidelines:
  • Empirical management of intravascular catheter related infections
  • Pathogen specific therapy for intravascular catheter related infections
  • Management of patients with tetanus-prone wounds
  • Updated useful contact numbers section 
  • Updated notifiable diseases section

Version 3.62 November 2020

• Removed duplicate HCID section
• Added icons to the guidelines

Version 3.61 November 2020

• Kawasaki disease guideline updated - link included
• Management of Infected CNS shunts updated
• Lymphadenitis (mild-moderate) guideline updated
• Lymphadenitis (severe) guideline updated
• Epiglottitis guideline updated
• Campylobacter enteritis guideline updated
• Pharyngitis and Tonsilitis guideline updated
• Bacterial tracheitis guideline updated
• Following adenoidectomy tonsillectomy guideline updated
• Otitis media guideline updated
• Paed malaria updated
• Addition of link to microbiology intranet page

Version 3.6 August 2020

• Malaria guideline in the process of being updated.

Version 3.55 July 2020

• Aspiration pneumonia guideline - dosing tables added
• New Guideline: Impetigo
• Toxic shock guideline updated
• Necrotising fascitis guideline updated
• Wound infection guideline renamed as Surgical Site infection guideline and updated
• Soft tissue injury, contaminated guideline updated

Version 3.54

• Mild - moderate CAP guideline updated
• Severe CAP guideline updated
• Aspiration pneumonia guideline updated
• Lower UTI guideline updated
• Pyelonephritis updated
• Vancomycin IV -  Intravenous Vancomycin Paediatric Dosing Guideline (if eGFR 51ml/min/1.73m² or more) section updated
• COVID-19 section updated

Version 3.53 

• Post-exposure Prophylaxis for Paediatrics  - no changes to drug recomendations, updated to reflect use of generic products
• COVID-19: Links to adult microguide for the guidelines in this folder

Version 3.52

• COVID-19 guidelines added

Version 3.51 (January 2020)

• Technical change - no clinical changes

Version 3.5 (January 2020)

• Technical change - no clinical changes

Version 3.4 (January 2020) 

• New guidelines:
  • Spinal infection
  • Penetrating intracranial inujry/gunshot
  • Brain abscess
  • Post-operative meningitis
• Updated treatment guidelines:
  • Enteric fever/typhoid
  • Cellulitis (mild-moderate)
  • Cellulitis (severe)
  • Urinary tract
  • Intra-abdominal infections
  • Colorectal surgery
  • Penetrating abdominal trauma
• Updated prophylaxis guidelines:
  • Head and neck surgery (+/- oral lesions)
  • Craniofacial surgery - both sections
  • Elective hand surgery in children 

Version 3.3 (January 2020)

• Bone and joint infection updated with latest guidance
• Sepsis and meningitis folder changed to sepsis and meningitis section updated
• Removed sepsis identification and management as all information now detailled on EPR
• Open fracture guidance updated
• Mass casualty guidance updated
• Addendum - CPE Infection control guidelines were updated in this version

Version 3.2 (September 2019)

• Appendicitis pathways and guideline
• Gastro-intestinal surgery prophylaxis

Version 3.1 (September 2019)

• Lower UTI - Added alternative to cefalexin during period of shortage for patient needing liquid formulation 
• Recurrent UTI - cefalexin removed as alternative option
• Bites - updated

Version 3 (August 2019) - typo corrected from version 2.8

• Neonatal guidelines removed - See interim neonatal guidelines available from the neonatal unit

Version 2.8 (June 2019)

• Lower UTI guidance updated
• Pyelonephritis guidance updated
• Blood cultures: action to take
• Sepsis or meningitis: Amoxicillin indicated changed to less than 1 month only
• Vancomycin dosing guidance updated

Version 2.7 (June 2019)

• Updated hyperlink to Febrile neutropenia guidelines.
• Updated 'Prevention of secondary meningococcal disease' section

Version 2.6 (February 2019)

• Change to IV vancomycin dosing guidance
• New Intravascular cathether management guidance
• Micturating cystourethrogram (MCUG) guidance updated
• Urinary tract section - Lower UTI  guidance updated
• Cleft lip and palate guidance updated
• Periorbital guidance updated
• New Infected eczema guidance (Bacterial mild-moderate, Bacterial severe and Herpeticum)
• Otitis media updated to state "Consider no antibacterial treatment for 72 hours"

Version 2.1 (May 2018)

• New items:
  • Neonatal antimicrobial guidelines 
  • Paediatric vancomycin dosing guideline 
  • Paediatric teicoplanin dosing guideline 

Version 2 (February 2018)

• PEP - Post-exposure Prophylaxis for Paediatrics added to Paediatric MicroGuide 

This is version 9 (v 1.9) of the OUHFT Paediatric antimicrobial guideline on the MicroGuide Portal.

New this version (July 2017):

• Updated C Diff section
• Updated MRSA decolonisation section

For any comments, enquiries or suggestions for improvement, please contact antimicrobialpharmacist@oxnet.nhs.uk