National Antimicrobial Guideline (NAG) Primary Care

SetelDoc
Clinical Pathways 2026
C1: Bronchitis & Pneumonia
C2: Acute Otitis Media
C3: Acute Pharyngitis
C4: Acute Rhinosinusitis
C5: Acute Gastroenteritis
C6: SSTI / Skin Infection
C7: UTI (Non-Pregnant)
C8: UTI (ASB Pregnancy)
C9: UTI (Symptomatic Pregnancy)
Bronchitis & Pneumonia NAG 4th Edition (2024)
Acute Bronchitis: Viral origin. Antibiotics NOT needed. Use symptomatic treatment and bronchodilators if wheezing.
Adult Pneumonia (5-7 Days)
PatientAntibioticDosing
No ComorbAmoxycillin (Pref)500-1000mg q8h
With ComorbAmoxy/Clav (Pref)625mg q8h
Paediatric Pneumonia (5 Days)
Preferred: Amoxicillin 80-90mg/kg/day PO q8-12h.
Weight BandDosing (q12h)
3-5kg: 250mg6-9kg: 375mg10-14kg: 500mg15-19kg: 750mg
Observation: If TM intact & non-severe (T < 39°C), observe for 48-72h with analgesia before starting antibiotics.
Adult Dosing (5-7 Days)
StatusAntibioticDosing
PreferredAmoxycillin500mg PO q8h
AlternativeAmoxy/Clav625mg PO q8h
Paediatric Dosing (80-90mg/kg/d)
Duration: < 2 yrs (7-10 days) | ≥ 2 yrs (5-7 days). Use 14:1 Amoxy/Clav ratio if amoxicillin used within 30 days.
Strep Score: Antibiotics only if Score ≥ 3.
Adult Dosage (5-10 Days)
AntibioticDosing
Penicillin V500mg q6h or 1g q12h
Amoxicillin500mg q8h
Paediatric Dosage (10 Days)
AntibioticDosing (Max 1g/day)
Amoxicillin50mg/kg/day PO q12-24h
Likely ABRS: Fever >38°C, discoloured mucus, double sickening, or severe pain.
Adult & Paeds (5 Days)
AdultAmoxy/Clav 625mg q8h
PaedsAmoxycillin 80-90mg/kg/d q12h
Alarm Symptoms: Periorbital edema, double vision, or visual changes → REFER IMMEDIATELY.
Antibiotics: NOT needed for standard viral AGE. Focus on ORS and clear fluids.
Referral Criteria
  • High grade fever > 3 days or signs of sepsis.
  • Dysentery: Passage of grossly bloody stool.
  • Immunocompromised host.
Abscess: Primary Rx is I&D. Antibiotics (5-7 days) only if extensive cellulitis or comorbidities.
Cellulitis Adult (5-10 Days)
AntibioticDosing
Cephalexin1000mg PO q12h
Cloxacillin500mg PO q6h
Paediatric SSTI (5-7 Days)
Weight >25kg: Use adult dosing.
AntibioticDosing (Max 2g/day)
Cephalexin25-50mg/kg/day PO q12h
Cloxacillin50-100mg/kg/day PO q6h
Adult Cystitis (5 Days)
StatusAntibioticDosing
PreferredNitrofurantoin100mg PO q12h (MR)
PreferredCephalexin500mg PO q6-12h
Contraindication: Nitrofurantoin if eGFR < 30 ml/min.
Diagnosis: Treat only if CFU ≥ 10⁵ (or ≥ 10⁴ for GBS).
ASB Management (5 Days)
AntibioticDosing
Cephalexin1-2g/day (divided 2-4x)
Nitrofurantoin100mg PO q12h (MR)
Symptomatic Pregnancy: Send urine C&S and start immediate treatment (5-7 days).
PreferredCephalexin 1-2g/day (divided)
PreferredNitrofurantoin 100mg q12h (MR)
Avoid: Nitrofurantoin in 3rd trimester. Amoxy/Clav increases NEC risk in preterms.
Top
VIP
Portal
Login | Out
Help
Scroll to Top