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