Paediatric Stewardship

SAPG Paediatric Stewardship Steering Group (PSSG) aims to provide national consensus on use of antibiotics and investigations to optimise prophylaxis, empirical and targeted treatment strategies and to minimise unnecessary use and resistance development.

Antibiotic management of Group A Streptococcus (GAS, Strep. pyogenes) infection in children age 18 and under

Levels of Group A Strep infections in Scotland have now returned to normal seasonal levels and the SAPG guidance created in December 2022 has been withdrawn (08/02/23).  Antibiotics for children with a sore throat should be considered for those with a FeverPAIN score of 4 or more.

Updated advice on antimicrobial management of Clostridioides difficile (C.diff) Infection (CDI) in children

SAPG and PSSG has reviewed the National Institute for Health and Care Excellence (NICE) guideline on Clostridioides difficile infection: antimicrobial prescribing and has made updated recommendations below.

Updated advice on antimicrobial management of Clostridioides difficile (C.diff) Infection (CDI) in children

Paediatric CDI decision tool

(Please see here for updated SAPG advice on CDI in adults)

Urinary tract infections:

In collaboration with NHS Education for Scotland we have developed an education module and supporting quality improvement tools to optimise the use of antibiotics for prevention and treatment of urinary tract infection in children.

Empiric Antibiotic Guidelines:

BSAC Paediatric Pathways is a useful resource for antimicrobial management teams and boards to use to support development of empirical paediatric antimicrobial guidelines in secondary care. The guidance is comprehensive in its inclusion of infections, and is well-resourced and user friendly offering useful direction in the management of some less common infections.  The guideline is under a process of continual review and update by the UK PAS group, supporting up to date practice. Prescribing recommendation is based on UK data and consideration should be given to local resistance patterns and prescribing in the Scottish context.

EUCAST change in dosing recommendations:

Greater Glasgow and Clyde have created the following guideline to support the change in EUCAST recommendations in the paediatric population:

NHSGGC - Isolates reported as 'I' (susceptible increased exposure) - dosing schedules for neonates and children (

SAPG review of Antimicrobial Management Team workforce (March 2022)  highlighted the need to improve paediatric stewardship across Scotland