Infection

JULY 2026 ANTIMICROBIAL UPDATES

FLUOROQUINOLONES: LAST RESORT, NOT FIRST REACH

Ciprofloxacin, ofloxacin and levofloxacin should only be prescribed when other commonly recommended antibiotics are inappropriate i.e. resistance, contraindication, intolerance, or treatment failure, due to the risk of disabling and potentially irreversible side effects.

Not for mild or self-limiting infection.

For more information see:

– Fluoroquinolone antibiotics: must now only be prescribed when other commonly recommended antibiotics…)

– [which should prompt stopping immediately at the first sign. Take special care in patients over 60, with renal impairment or solid-organ transplants, and avoid co-prescribing a corticosteroid [GOV.UK](Fluoroquinolone antibiotics: must now only be prescribed when other commonly recommended antibiotics…) .

– Counsel every patient, give them the MHRA patient sheet and report suspected reactions via Yellow Card.

GUIDELINES

Antimicrobial website (UHL)

Antimicrobial Guidance for Primary Care

  • Antimicrobial policy

Fluoroquinolones

Principles of Treatment 

  • Delayed Antibiotic Prescribing

Implementing Back-up (delayed) Antibiotic Prescribing

Supporting Resource: Prescribing instructions for SystmOne and Emis Users

Supporting Resource: Video Guide for SystmOne Users

Supporting Resource: Video Guide for Emis Users

  • Gastro-intestinal tract infections

Acute Diverticulitis

Eradication of H.pylori

Infectious Diarrhoea

Traveller’s diarrhoea

  • Genital tract infections

Bacterial vaginosis

Chlamydia

Vaginal candidiasis

  • Urinary tract infections

Acute Prostatitis

Acute Pyelonephritis in Adults

  • Respiratory tract infections

Acute Cough

Community Acquired Pneumonia (CAP)

Otitis media

Pharyngitis / Sore Throat / Tonsillitis

Sinusitis

Whooping Cough/ Pertussis

  • Skin / soft tissue infections

Acne Vulgaris

Dermatophyte infection of nail

Diabetic Foot Infection

Human and Animal Bites

Impetigo

Infected Leg Ulcers

Lyme Disease

Paronychia

  • Other Guidelines

Catheterised Patients – Antimicrobial Management

Cellulitus Teicoplanin pathway

Cellulitis Pathway – Pharmacies that Stock Teicoplanin

Clostridium difficile – Management in Primary Care

LLR Guidelines on Management of Lower Recurrent Urinary Tract Infections in Adults

Treating your infection (UTI)- Patient Advice Sheet

Multi-resistant Lower Urinary Tract Infection (UTI) Guidance in Primary Care

NICE NG165 Covid-19 Rapid Guideline: Managing Suspected or Confirmed Pneumonia in Adults in the Community

NHS England Letter: Primary Care Actions Following Interleukin 6 inhibitor treatment for Covid

Palliative Care Drugs and Emergency Antibiotics – Pharmacies and Stock

Shingles Vaccine Patient Leaflet