netFormulary NHS
Sandwell & West Birmingham
Clinical Commissioning Group
News Title

NICE Rapid Guidelines

NICE is supporting the NHS and social care by developing a series of rapid guidelines on caring for patients with suspected and confirmed COVID-19 infection, and patients without COVID-19 infection, in a number of clinical areas.

These include

  1. Severe asthma
  2. Managing suspected or confirmed pneumonia in adults in the community
  3. Rheumatological autoimmune, inflammatory and metabolic bone disorders
  4. Managing symptoms (including at the end of life) in the community
  5. Cystic Fibrosis
  6. Community-based care of patients with Chronic Obstructive Pulmonary Disease (COPD)
  7. Dermatological conditions treated with drugs affecting the immune response
  8. Gastrointestinal and liver conditions treated with drugs affecting the immune response
  9. Acute myocardial injury
  10. Acute use of non-steroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19
  11. Chronic Kidney Disease
  12. Interstitial Lung Disease



NICE have now published the COVID-19 rapid guideline: Managing suspected or confirmed pneumonia in adults in the community

Please refer to NICE guidance (above) for full details. Extract from this document:

  • As COVID19 pneumonia is caused by a virus, antibiotics are not effective.
  • Do not offer an antibiotic for the treatment or prevention of pneumonia if COVID 19 is the likely cause, and symptoms are mild.
    • Inappropriate antibiotic use may reduce availability if used indiscriminately
    • Broad spectrum antibiotics may lead to a C-Diff infection as well as increasing antibiotic resistance
  • Offer an oral antibiotic for treatment of pneumonia in people who can or wish to be treated in the community if:
    • The likely cause is bacterial or
    • The cause is unclear and symptoms are more concerning or
    • They are at high risk of complications. For example, they are older or frail, or have a pre-existing comorbidity such as immunosuppression or significant heart or lung disease (e.g. bronchiectasis or COPD), or have a history of severe illness following previous lung infection.

Additional notes:

  • Inappropriate use of antibiotics can cause more harm than good
  • Follow current NICE guidance and do not change evidence based prescribing behaviours and advise self-care where clinically appropriate
  • Only prescribe rescue packs, including antibiotics, if they are part of the patients existing asthma/COPD plan
  • NHS England are due to advise no prepack antibiotic use in care homes
  • The antibiotic supply line is already stressed with out of stocks. Prudent use is advised
  • Refer to guidelines and prescribe no more than the usual quantity as over-prescribing will put more pressure on the national supply chain.