Further Alterations to Antimicrobial Classes

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Further to recent correspondence regarding Colistin being moved to a Class 3 product on the PVS list Prescribing Principles for Antimicrobials, PVS has further reviewed the scientific literature regarding the use of Amoxycillin/clavulanic acid combination and, in particular, its link with extended-spectrum beta lactamase (ESBL) producing bacteria. As clavulanic acid is able to neutralise many beta-lactamases and ESBLs, and may also select for AmpC beta lactamase producing bacteria, it was felt that this put it alongside the third and fourth generation cephalosporins and should be reserved for special use. We have decided, therefore, that this too, should be moved into Class 3 in our Prescribing Principles for Antimicrobials.

CLASS 3  ARE PRODUCTS OF LAST RESORT; ONLY TO BE USED WHEN NO OTHER OPTIONS ARE AVAILABLE AND SUPPORTED BY LABORATORY SENSITIVITY TESTS OR IN EXTREME CIRCUMSTANCES WHEN ALL ELSE HAS FAILED.

You can find the updated list for download here.  Please destroy any printed copies of previous versions of this document.