The belief that antibiotic use or misuse is a major driving force for
antibiotic resistance is now an established and recognised fact. It is thus imperative for all healthcare
practitioners to play their role in combating this threat so as to preserve the effectiveness and the
relevance of current antibiotics in our practice. Rational antibiotic use must be viewed as a skill that all
medical practitioners must acquire so as to ensure effective, safe and appropriate
patient care. Appropriate treatment in our current approach is not only about using an antibiotic that the
organism is sensitive to but also includes the use of one that will have minimal collateral
damage to the ambient bacterial flora...This document is a collaborative effort involving a
large number of specialists from within the Ministry of Health; spanning all major clinical disciplines and bringing
together the expertise and experience of many senior clinicians from all regions of the country. The
recommendations are based on current clinical evidence similar to the approach taken in the
production of clinical practice guidelines, the current list of antimicrobials in the ministry drug
formulary, the pattern of antimicrobial resistance seen in the country as well as the current practice
within Ministry of Health hospitals.
Nonetheless because of the large spectrum of clinical infections; some of which
involved several disciplines, consensus decision-making involving the relevant stakeholders was
pursued whenever differences of opinion occurred. While the editorial committee aimed to
address all common infections in the numerous clinical settings within the ministry, they
also took due cognizance of the need to keep the document concise for the purpose of producing
a pocket handbook. Hence, the editorial committee decided to include only the more common
and critical infections for mention. Less common infections and those seen only in
specialised areas, regrettably, had to be omitted. Most portions of the document are formatted in a
standardised manner so as to provide uniformity and to make it more reader friendly.
Antibiotic choices are classified into preferred and alternative recommendations
based on clinical evidence of effectiveness, adverse effects, potential of collateral damage as
well as cost and access. References have been inserted whenever possible.
This document aims to guide clinicians in their empirical choice of
antimicrobial agents; balancing the need to get the right choice from the outset and the necessity to contain
antimicrobial misuse so as to preserve future treatment options especially in the current era of
growing antimicrobial resistance. Nonetheless, this document merely acts as a guide and each case must
still be accessed according to its own merits.