Home Guidelines National Antimicrobial Treatment Guidelines 2023 – Nepal

National Antimicrobial Treatment Guidelines 2023 – Nepal

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National Antimicrobial Treatment Guidelines 2023 nepal
National Antimicrobial Treatment Guidelines 2023 nepal

In Nepal, the National Antibiotic Treatment Guidelines were released by the Ministry of Health and Population in 2014 initially to prevent and control the Antimicrobial Resistance (AMR) developed by the World Health Organization’s South-East Asia Regional Office.

These guidelines of National Antimicrobial Treatment Guidelines aimed to address the resistance of antibiotics by optimizing the use of available antimicrobial agents that will help to reduce selection pressure through appropriate control measures, change the behavior of prescribers and communities to ensure rational use, and combat AMR through national coordinated efforts.

The Brief objective and principles for the National Antimicrobial Treatment Guidelines is stated as below in gist as well as pdf format

Objectives of National Antimicrobial Treatment Guidelines

  • To offer guidance for the optimal use of antimicrobials in various infectious conditions and for prophylactic purposes, taking into account the cumulative antibiogram from National AMR surveillance.
  • To promote the preferential use of antimicrobials from the “Access” group, while ensuring judicious use of those from the “Watch” and “Reserve” groups.

GENERAL PRINCIPLES of Antimicrobial Treatment

National Antimicrobial Treatment Principle

GENERAL PRINCIPLES of Antimicrobial Treatment

Empirical Therapy of Antibiotics

Antibiotic treatment is considered empirical when it is administered in the absence of microbiological confirmation or while awaiting pending reports. Reevaluation of empirical antibiotics must be conducted after 48-72 hours and once the reports become available.

Important considerations on Antibiotic use

Determine if antibiotic therapy is necessary. Discontinue if the cause is determined to be non-infectious. Seek assistance from the Antimicrobial Stewardship (AMS) team within the institution, if available.

Evaluate the possibility of using a narrow-spectrum antibiotic based on the reports. Consider de-escalating the antibiotics based on the clinical condition and available reports.

  • Assess if switching to monotherapy is appropriate (if initially using a combination).
  • Evaluate the feasibility of changing the route of administration to oral.
  • Adjust the dosage based on renal and hepatic functions, if necessary.
  • Check for potential drug interactions with other medications being used.
  • Determine if any laboratory parameters need monitoring during therapy.

These recommendations serve as a treatment guide and do not replace the clinical judgment of the responsible physician after a comprehensive assessment of each case.

Prescriptions should clearly include

  • Indication for antibiotic use
  • Formulation; Capsule/Tablet or Injection.
  • Route of administration (e.g., IM or IV), infusion rate for IV, and dosing.
  • Start date, review date, stop date, or duration.

Consider implementing transmission-based precautions and isolation for patients with infectious diseases and drug-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE),drug-resistant tuberculosis (DRTB), Clostridioides difficile, etc.

Precautions to observe

Standard precautions:

Practice proper hand hygiene, respiratory hygiene, sharps safety, safe injection practices, use sterile instruments and devices, maintain clean and disinfected environmental surfaces, and use gloves and protective clothings . Use mouth, nose, and eye protection during procedures.

Contact precautions:

Ensure appropriate patient placement, limit patient transport, use disposable or dedicated equipment, perform cleaning and disinfection of the room, and use gloves gown.

Droplet precautions:

Have patients wear masks for source control, ensure appropriate patient placement, limit patient transport, and provide masks for healthcare personnel.

Airborne precautions:

Ensure patients wear masks for source control, place them in isolation rooms, limit patient transport, restrict susceptible healthcare personnel from entering the room, and have healthcare personnel wear N-95 masks or higher-level respirators.

Please note that these precautions are subject to local guidelines and protocols and may require additional measures based on the specific circumstances

National Antimicrobial Treatment Guidelines 2023 Download

the National Antimicrobial Treatment Guidelines 2023 of Nepal can be downloaded or seen online here

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