Antibiotic Stewardship

Community-Acquired Pneumonia — Mild (CURB65 0–1)

First Line

Amoxicillin

500mg–1g three times daily PO
Duration: 5 days
Add clarithromycin 500mg bd if atypical organism suspected (e.g. Mycoplasma, Legionella features)

Penicillin Allergy

Doxycycline

200mg od day 1, then 100mg od
Duration: 5 days total
Take with water, upright

💡 CURB65: 1 point each for Confusion, Urea >7 mmol/L, Resp Rate ≥30, BP systolic <90 or diastolic ≤60, age ≥65. Score 0–1 = outpatient treatment appropriate. Consider CRP to guide antibiotic decision.

🔄 Review at 48–72h with culture results. De-escalate if cultures identify a narrower-spectrum option. Stop if cultures negative and clinical diagnosis uncertain.

PHE/UKHSA Pneumonia Guideline · BTS CAP Guidelines 2009 · NICE CG191

Community-Acquired Pneumonia — Moderate (CURB65 2)

First Line

Amoxicillin + Clarithromycin

Amoxicillin 500mg tds PO
+ Clarithromycin 500mg bd PO
Duration: 7 days
Consider hospital admission — clinical assessment required

Penicillin Allergy

Doxycycline + Clarithromycin

Doxycycline 200mg day 1, then 100mg od
+ Clarithromycin 500mg bd
Duration: 7 days

🔄 Review at 48–72h. Step down from IV to oral when patient tolerating oral intake and haemodynamically stable. Use C-reactive protein (CRP) to guide duration.

BTS CAP Guidelines · NICE CG191 · PHE Guidance

Community-Acquired Pneumonia — Severe (CURB65 3–5)

First Line (IV)

Co-amoxiclav + Clarithromycin

Co-amoxiclav 1.2g tds IV
+ Clarithromycin 500mg bd IV
Duration: 7–10 days (step down to oral when stable)
Admit — consider HDU/ITU if CURB65 4–5

Penicillin Allergy

Levofloxacin

Levofloxacin 500mg bd IV
Duration: 7–10 days
Caution: QTc prolongation — check ECG, avoid with other QT-prolonging drugs

⚠️ Send blood cultures x2, sputum MC&S, urinary Legionella antigen, urinary pneumococcal antigen, viral swab. Consider HIV test in high-risk patients. Seek microbiology advice.

🔄 Review at 48–72h with culture results. Narrow spectrum when possible. De-escalate from IV to oral when: temp <37.5°C for 24h, haemodynamically stable, improving CRP, tolerating oral intake.

BTS CAP Guidelines 2009 · NICE CG191 · PHE Severe CAP Guidance

COPD Exacerbation (Infective — purulent sputum)

First Line

Amoxicillin or Doxycycline

Amoxicillin 500mg tds PO — 5 days
OR Doxycycline 200mg day 1, then 100mg od — 5 days
Antibiotics only if purulent sputum (increased sputum purulence is key)

Penicillin Allergy

Doxycycline

Doxycycline 200mg od day 1, then 100mg od
Duration: 5 days

💡 Do not prescribe antibiotics for COPD exacerbation without purulent sputum (no evidence of benefit). CRP-guided therapy: if CRP <20 mg/L unlikely bacterial — advise against antibiotics; 20–40 consider; >40 recommend. Also prescribe: bronchodilators, prednisolone 30mg od 5 days, ensure adequate oxygenation (target SpO₂ 88–92% in COPD).

🔄 5-day course is sufficient for most COPD exacerbations. No evidence for longer courses. Sputum MC&S in recurrent/severe exacerbations.

NICE NG115 (COPD) · GOLD Guidelines · PHE COPD Exacerbation Guidance

Acute Sinusitis

First Line (if indicated)

Phenoxymethylpenicillin

Phenoxymethylpenicillin 500mg qds PO
Duration: 5 days
Only if symptoms persist >10 days OR severe symptoms/complications

Penicillin Allergy

Doxycycline

Doxycycline 200mg od day 1, then 100mg od
Duration: 5 days

💡 Most sinusitis is viral. Do NOT prescribe antibiotics in first 10 days (self-limiting). Offer: intranasal decongestant (xylometazoline), nasal saline irrigation, paracetamol/ibuprofen. Delayed prescription strategy is appropriate. Refer urgently if periorbital swelling, severe headache, visual changes, or meningism.

🔄 Antibiotics only after 10 days of symptoms — most cases resolve without. High rate of viral aetiology (90%+). NICE NG196 recommends no antibiotics or delayed prescription.

NICE NG196 · PHE TARGET Sinusitis Guidance

Tonsillitis / Pharyngitis (Centor ≥3)

First Line

Phenoxymethylpenicillin

500mg four times daily PO
Duration: 10 days
(Centor criteria ≥3: exudate, tender anterior cervical lymph nodes, fever, no cough)

Penicillin Allergy

Clarithromycin

Clarithromycin 250mg bd PO
Duration: 5 days
(Note: increasing macrolide resistance in Strep A)

⚠️ Do NOT use amoxicillin/ampicillin if glandular fever (EBV) cannot be excluded — risk of morbilliform rash. Use FeverPAIN or Centor score. Most sore throats are viral. 40% of Centor ≥3 are bacterial.

🔄 10-day penicillin course needed to eradicate Group A Streptococcus and prevent rheumatic fever. Do not shorten course.

NICE NG84 · PHE TARGET Sore Throat Guideline · Centor RM et al.

Lower UTI — Women (Uncomplicated)

First Line

Nitrofurantoin MR or Trimethoprim

Nitrofurantoin MR 100mg bd — 3 days (if eGFR ≥45)
OR Trimethoprim 200mg bd — 3 days (if local resistance <20%)
Take with food (nitrofurantoin)

Allergy / Trimethoprim Resistant

Pivmecillinam

Pivmecillinam 400mg loading dose, then 200mg tds
Duration: 3 days
Or fosfomycin 3g single sachet (send MSU first)

💡 Send MSU before antibiotics. Dipstick alone insufficient for diagnosis. Diagnose on symptoms + dipstick in non-pregnant women. Trimethoprim: check local resistance data — avoid if >20% resistance rate. Nitrofurantoin: avoid if eGFR <45.

🔄 3-day course is sufficient for uncomplicated lower UTI in women. Review MSU results at 48–72h. Asymptomatic bacteriuria does not require treatment (except in pregnancy).

NICE NG109 · PHE/UKHSA UTI Guidance · PHE Antibiotic Prescribing Toolkit

Lower UTI — Men

First Line

Trimethoprim or Nitrofurantoin MR

Trimethoprim 200mg bd — 7 days
OR Nitrofurantoin MR 100mg bd — 7 days (if eGFR ≥45)
Always send MSU

If Prostatitis Suspected

Ciprofloxacin or Trimethoprim

Ciprofloxacin 500mg bd — 28 days (prostatitis)
OR Trimethoprim 200mg bd — 28 days (prostatitis)
Quinolones penetrate prostate better

⚠️ UTI in men is not "uncomplicated" — consider structural abnormality, prostatitis, or STI (especially in younger men). Refer urology if recurrent. Send MSU before treatment — longer course needed (7 days minimum).

🔄 Review MSU results at 48–72h. Adjust antibiotic based on sensitivities. Consider urology referral for men with recurrent UTIs or any structural abnormality.

NICE NG109 · PHE/UKHSA Guidance

Pyelonephritis (Outpatient)

First Line

Cefalexin or Trimethoprim

Cefalexin 500mg qds PO — 7–10 days
OR Trimethoprim 200mg bd — 14 days
Send MSU and blood cultures before starting

Allergy / Severe / Resistant

Ciprofloxacin

Ciprofloxacin 500mg bd PO — 7 days
Caution: QTc prolongation, avoid with other QT-prolonging drugs
Consider admission if vomiting, systemically unwell, or pregnant

⚠️ Admit if: pregnancy, unable to tolerate oral medications, haemodynamically unstable, immunocompromised, or failed outpatient treatment. Send MSU and blood cultures before antibiotics.

🔄 Review blood culture and MSU results at 48–72h. Step down/de-escalate if sensitivities allow. If no improvement at 48h, reassess — consider admission and IV therapy.

NICE NG109 · PHE Guidance · EAU Guidelines (Urological Infections)

Catheter-Associated UTI (CAUTI)

First Line (if symptomatic)

Co-amoxiclav

Co-amoxiclav 625mg tds PO — 7 days
ONLY if symptomatic (fever, rigors, loin pain, haematuria, delirium)
Change catheter before starting antibiotics if possible

Penicillin Allergy

Cefalexin or Ciprofloxacin

Cefalexin 500mg qds PO — 7 days
OR Ciprofloxacin 500mg bd — 7 days (if resistant to cefalexin)
Always guided by MSU sensitivities

⚠️ Do NOT treat asymptomatic bacteriuria in catheterised patients — treat only if symptomatic. Always send catheter urine sample before antibiotics. Change catheter before treatment if possible — this alone can resolve symptoms.

🔄 Review MSU results at 48–72h. If resistant organism, escalate based on sensitivities. Remove catheter as soon as clinically feasible.

NICE NG109 · EPIC3 Guidelines · PHE CAUTI Guidance

Non-Purulent Cellulitis

First Line

Flucloxacillin

Flucloxacillin 500mg–1g four times daily PO
Duration: 5–7 days (extend to 10–14 days if severe or slow response)
Mark border of erythema with pen to assess progression

Penicillin Allergy

Clarithromycin or Doxycycline

Clarithromycin 500mg bd PO — 5–7 days
OR Doxycycline 100mg bd PO — 5–7 days

💡 Erysipelas (sharply demarcated, raised border) — typically Group A Streptococcus. Cellulitis (diffuse, poorly demarcated) — typically Staph aureus or Streptococcus. Mark border of erythema at presentation. Elevate affected limb. Consider predisposing factors (tinea pedis, lymphoedema).

🔄 Review at 48–72h. If worsening or no improvement, consider IV therapy, blood cultures, and skin swab. Recurrent cellulitis: consider long-term prophylaxis with phenoxymethylpenicillin 250mg bd.

CREST Guidelines (Cellulitis) · BIA Guidelines · PHE Guidance

Purulent Cellulitis / Infected Wound

First Line

Flucloxacillin

Flucloxacillin 500mg qds PO — 5–7 days
Send wound swab (pus preferred)
Incision and drainage if abscess present

MRSA Risk / Allergy

Doxycycline or Co-trimoxazole

Doxycycline 100mg bd PO — 5–7 days
OR Co-trimoxazole 960mg bd PO — 5–7 days
Both active against community MRSA. Check sensitivity.

⚠️ If abscess: incision and drainage (I&D) is primary treatment — may not need antibiotics after I&D if immunocompetent. Send pus for MC&S. MRSA risk factors: previous MRSA, care home resident, recent hospitalisation, healthcare worker.

🔄 Review swab results at 48–72h. If MRSA confirmed, ensure antibiotic active against MRSA. Consider decolonisation protocol.

CREST Guidelines · PHE Skin Infection Guidance

Severe / Hospital Cellulitis (IV)

First Line (IV)

Flucloxacillin IV

Flucloxacillin 1–2g four times daily IV
Step down to oral flucloxacillin when improving
Blood cultures x2 before first dose

Penicillin Allergy / MRSA Risk

Vancomycin or Teicoplanin

Vancomycin IV by weight-based infusion (dose by levels — target AUC 400–600 mg·h/L)
OR Teicoplanin (loading 6–12mg/kg q12h x3, then od)
Discuss with microbiology

⚠️ Admit if: systemic sepsis, rapid progression, facial cellulitis, periorbital involvement, immunocompromised patient, failed oral therapy. Blood cultures before antibiotics. Consider necrotising fasciitis if severe pain out of proportion, crepitus, rapid progression — surgical emergency.

🔄 Early IV-to-oral switch when: temperature normalising, erythema not spreading, tolerating oral intake. Typically 24–48h IV then oral step-down reduces LOS.

CREST Guidelines · PHE Guidance · NICE Quality Standards

Clostridioides difficile (C. diff) — Mild to Moderate

First Line

Metronidazole

Metronidazole 400mg tds PO — 10 days
Stop the precipitating antibiotic if possible
Review at 5 days — if no improvement, escalate to vancomycin

Severe / Recurrent

Vancomycin PO or Fidaxomicin

Vancomycin 125mg qds PO — 10–14 days
OR Fidaxomicin 200mg bd PO — 10 days (recurrent CDI)
IV metronidazole if unable to take oral (add-on)

⚠️ Severe C. diff: WBC >15 × 10⁹/L, creatinine rise ≥50%, temp >38.5°C, or signs of severe colitis — use vancomycin PO as first line. Fulminant: surgical review urgently. Contact precautions — alcohol gel ineffective (use soap and water). Stop PPIs and any unnecessary antibiotics.

🔄 Test of cure not recommended (tests remain positive after clinical resolution). Recurrent CDI (within 8 weeks): fidaxomicin preferred over vancomycin. Faecal microbiota transplantation (FMT) for multiple recurrences.

ESCMID CDI Guidelines 2021 · PHE CDI Guidance · NICE NG199

H. pylori Eradication

First Line (Triple Therapy)

Clarithromycin + Amoxicillin + PPI

Clarithromycin 500mg bd
+ Amoxicillin 1g bd
+ PPI (e.g. omeprazole 20mg bd)
Duration: 7 days (14 days if poor eradication rates locally)

Amoxicillin Allergy

Clarithromycin + Metronidazole + PPI

Clarithromycin 500mg bd
+ Metronidazole 400mg bd
+ PPI bd
Duration: 7 days

💡 Confirm eradication at ≥4 weeks after completing treatment with 13C-urea breath test or stool antigen test (not serology — remains positive after eradication). Second-line (failed triple therapy): quadruple therapy — bismuth subcitrate, tetracycline, metronidazole + PPI 10–14 days. Check local clarithromycin resistance data.

🔄 Always confirm eradication (urea breath test ≥4 weeks post-treatment). Rising clarithromycin resistance in UK — consider bismuth quadruple therapy if local resistance >15%.

NICE CG184 · ESPGHAN/ESPGAN HP Guideline · PHE Guidance

Bacterial Meningitis (Empirical)

Empirical First Line (IV — URGENT)

Cefotaxime or Ceftriaxone + Dexamethasone

Cefotaxime 2g four times daily IV
OR Ceftriaxone 2g bd IV
+ Dexamethasone 0.15 mg/kg qds IV x4 days
Start dexamethasone before or with FIRST antibiotic dose
If >55 years or immunocompromised: ADD Amoxicillin 2g 4-hourly IV (Listeria cover)

Beta-Lactam Allergy

Discuss with Microbiology

Chloramphenicol 25mg/kg qds IV (if cephalosporin allergy)
OR Meropenem 2g tds IV (if severe penicillin allergy — discuss with micro)
Microbiology advice essential

🚨 EMERGENCY — do not delay antibiotics. If meningitis suspected: (1) Blood cultures x2, (2) IV antibiotics immediately, (3) CT head only if clinically indicated before LP (not if no focal neurology/papilloedema), (4) LP after CT or if safe. Dexamethasone must start with or before first antibiotic dose (CORSA trial — reduces deafness risk in pneumococcal meningitis). Notify Public Health for meningococcal cases.

🔄 Tailor therapy when CSF/blood culture results available. Meningococcal meningitis: 7 days ceftriaxone. Pneumococcal: 10–14 days. Stop dexamethasone if non-pneumococcal (e.g. meningococcal). Notify public health (meningococcal — prophylaxis for contacts).

NICE CG102 (Bacterial Meningitis) · Meningitis Research Foundation · PHE Guidance

Sepsis — Community-Acquired (Empirical)

First Line (IV — within 1 hour)

Piperacillin/Tazobactam

Piperacillin/tazobactam 4.5g tds IV
Infuse over 4 hours (extended infusion)
Send blood cultures x2 BEFORE first dose
Follow local Sepsis 6 bundle

Penicillin Allergy

Meropenem

Meropenem 1g tds IV
Discuss with microbiology
Consider risk of carbapenem resistance if used empirically

🚨 Sepsis 6 (Surviving Sepsis/NICE NG51): (1) Give O₂, (2) Blood cultures x2, (3) IV antibiotics within 1 hour, (4) IV fluid resuscitation (500mL bolus if hypotensive), (5) Serum lactate, (6) Urine output monitoring. Add source-specific antibiotic cover when source identified.

🔄 CRITICAL: Review at 48–72h with blood culture results. De-escalate to narrowest spectrum antibiotic. Stop if cultures negative and clinical picture improving. Consider stopping antibiotics if source not identified and patient improving (avoid 7-day empirical courses without clear indication).

NICE NG51 (Sepsis) · Surviving Sepsis Campaign Guidelines · PHE Sepsis Guidance

Sepsis — Hospital-Acquired (>48h post-admission)

First Line (guided by local policy)

Pip/Taz or Meropenem ± Vancomycin

Piperacillin/tazobactam 4.5g tds IV
OR Meropenem 1g tds IV (if local ESBL/AmpC risk or ICU setting)
Add Vancomycin IV (or Teicoplanin) if MRSA risk
Blood cultures x2 before first dose — mandatory

Microbiology Advice

Essential — local resistance patterns

Hospital-acquired sepsis must follow LOCAL antibiogram and microbiology guidance.
Local resistance to pip/taz, ESBL prevalence, and MRSA rates vary significantly.
Contact on-call microbiology.

⚠️ Hospital-acquired sepsis carries high MRSA, ESBL, and multi-drug resistant organism risk. Always follow local antibiogram data. Contact on-call microbiology. Send: blood cultures x2 (peripheral + from any lines), urine, wound swabs, sputum (if intubated — BAL). CXR.

🔄 Review daily. De-escalate aggressively once culture results available. Target duration: shortest effective course. Discuss with microbiology at 72h if cultures negative or clinical uncertainty.

NICE NG51 · PHE Hospital-Acquired Infection Guidance · Local Trust Guidelines

Chlamydia

First Line (Preferred)

Doxycycline

Doxycycline 100mg bd PO — 7 days
Higher efficacy than azithromycin (TITAN trial)
Contact trace and treat partners

Compliance/Preference

Azithromycin

Azithromycin 1g stat PO
Less effective than doxycycline (test-of-cure recommended)
Use only if doxycycline not appropriate

💡 Offer screen for other STIs (HIV, gonorrhoea, syphilis). BASHH guidance: doxycycline is preferred first line (TITAN trial 2019). Partner notification essential — all sexual partners in last 6 months. Abstain from sex until treatment complete and partners treated.

🔄 Test of cure not routinely needed after doxycycline. Recommend if: pregnant, rectal chlamydia, or symptoms persist. Partner notification essential.

BASHH Chlamydia Guidelines 2018 · PHE STI Guidance · TITAN Trial (2019)

Gonorrhoea (Uncomplicated Urogenital)

First Line

Ceftriaxone IM

Ceftriaxone 500mg IM single dose
ALWAYS send NAAT and culture before treatment
Test of cure (TOC) at 2 weeks — mandatory
If weight >150kg: use 1g

Cephalosporin Allergy

Discuss with GUM Specialist

Spectinomycin 2g IM (limited availability)
Gentamicin 240mg IM + azithromycin 2g PO
MUST discuss with GUM/sexual health specialist
Culture and sensitivity essential

⚠️ Antibiotic-resistant gonorrhoea is a major concern in the UK. ALWAYS: (1) Send NAAT and culture (including sensitivities) before treatment. (2) Perform test of cure (TOC) at 2 weeks after treatment. (3) Notify all contacts. (4) Refer to GUM if allergy or treatment failure. (5) Co-test for chlamydia, syphilis, HIV.

🔄 Test of cure MANDATORY at 2 weeks. If TOC positive: repeat culture, sensitivities, and discuss with GUM specialist. Report gonorrhoea treatment failures to PHE.

BASHH Gonorrhoea Guidelines 2019 · PHE Gonococcal Resistance to Antimicrobials (GRASP)

Syphilis (Primary / Secondary)

First Line (Specialist Only)

Benzathine Benzylpenicillin

Benzathine benzylpenicillin 2.4 MU IM
Single dose for primary/secondary syphilis
Administered in specialist GUM clinic
Jarisch-Herxheimer reaction may occur within 24h

Penicillin Allergy

Doxycycline

Doxycycline 100mg bd PO — 14 days
Requires desensitisation in pregnancy
GUM specialist referral essential

⚠️ Syphilis diagnosis and treatment must be managed by a GUM specialist. Confirm with serology (TPPA/TPHA, RPR/VDRL). Late latent or neurosyphilis: different regimen (procaine penicillin + probenecid or IV penicillin). Partner notification for all contacts in last 3 months (primary), 2 years (secondary/early latent). Screen for HIV, gonorrhoea, chlamydia.

🔄 Monitor RPR/VDRL titres at 3, 6, 12, 24 months — should decline 4-fold by 6 months. Refer for HIV testing. Contact trace. GUM follow-up essential.

BASHH Syphilis Guidelines 2015 (updated 2019) · PHE Guidance · WHO STI Treatment Guidelines

Septic Arthritis (Empirical, No MRSA Risk Factors)

First Line (IV)

Flucloxacillin IV ± Ceftriaxone

Flucloxacillin 2g four times daily IV
If Gram-negative risk (elderly, IV drug use, recent urinary procedure):
Add Ceftriaxone 2g od IV
Joint aspiration essential — MC&S mandatory

MRSA Risk / Allergy

Vancomycin

Vancomycin IV by levels (target AUC 400–600 mg·h/L)
Discuss with microbiology for dose optimisation
Continue IV at least 2 weeks before considering oral step-down

🚨 Septic arthritis is a surgical emergency — joint aspiration (or washout) must occur urgently. Delay causes permanent joint damage. Send synovial fluid for: cell count, Gram stain, MC&S, crystals. Blood cultures x2. Consider gonococcal arthritis in young sexually active adults (add ceftriaxone, send STI screen).

🔄 Review culture results at 48–72h. De-escalate to narrowest spectrum. Total IV duration typically 2 weeks then oral step-down guided by CRP and clinical response. Discuss with orthopaedics and microbiology.

NICE NG38 · PHE Bone and Joint Infection Guidance · BSR/BHPR Guidelines

Osteomyelitis (Empirical)

First Line (IV)

Flucloxacillin IV → Oral step-down

Flucloxacillin 2g qds IV — initially 4–6 weeks
Bone biopsy/tissue MC&S essential (do before antibiotics if possible)
Oral step-down: Flucloxacillin 1g qds PO
OR Rifampicin + Fusidic acid (biofilm-active — discuss with micro)

Penicillin Allergy

Clindamycin

Clindamycin 600mg qds IV — 4–6 weeks
Good bone penetration
Risk of C. diff — counsel patient
Oral step-down: Clindamycin 450mg tds PO

⚠️ Confirm microbiological diagnosis before antibiotics where possible (bone biopsy/tissue culture). MRI is investigation of choice. Longer courses needed (4–6 weeks IV typically). Rifampicin should only be added in combination (never monotherapy — rapid resistance). Discuss all osteomyelitis cases with microbiology and orthopaedics. Duration and route guided by response (CRP, ESR, imaging).

🔄 Microbiological confirmation is essential — empirical treatment alone is suboptimal. Oral bioavailability of some antibiotics (e.g. ciprofloxacin, clindamycin, rifampicin, fusidic acid) is excellent — early oral switch possible in stable patients. Minimum 4–6 weeks total for acute osteomyelitis; 3–6 months for chronic.

NICE NG38 · IDSA Osteomyelitis Guidelines · PHE Bone/Joint Infection Guidance

📋 Start Smart Then Focus — Antibiotic Stewardship Principles

PHE/UKHSA framework for responsible antibiotic prescribing in UK hospitals and primary care.

1 Take cultures before starting antibiotics. Blood cultures x2 (peripheral), site-specific cultures (urine, sputum, wound, CSF as appropriate). Do not delay antibiotics for cultures in sepsis — take simultaneously.
2 Document indication, drug, dose, route, and duration at time of prescribing. Every antibiotic prescription must have a clear indication and planned stop/review date written in the notes and drug chart.
3 Review at 48–72 hours with culture and sensitivity results. The formal antibiotic review at 48–72h is mandatory. Assess clinical response, microbiology results, and de-escalate.
4 De-escalate to narrowest spectrum antibiotic possible. Switch from broad to narrow spectrum when culture results allow. IV to oral as soon as clinically safe (usually 24–48h if tolerating oral, haemodynamically stable).
5 Stop antibiotics when not indicated. If cultures negative and clinical picture improving without antibiotic continuation, stop. Avoid prolonging empirical courses beyond 72h without clear indication.

⚠️ Important: This tool provides guidance based on PHE/UKHSA national recommendations. Always defer to local microbiology guidelines and your trust antibiogram — local resistance patterns must take precedence. This tool does not replace clinical assessment, local policy, or microbiological advice. For complex infections, contact on-call microbiology. For verified UK HCPs only.

🦠 Antibiotic Stewardship Tool

📋 Start Smart Then Focus — Antibiotic Stewardship Principles