Quality standard

Quality statement 3: Antibiotic treatment

Quality statement 3: Antibiotic treatment

Quality statement

People with suspected bacterial meningitis or suspected meningococcal disease receive intravenous (IV) antibiotics within 1 hour of their arrival at hospital. [2012, updated 2024]

Rationale

Suspected bacterial meningitis and suspected meningococcal disease are medical emergencies. Intravenous (IV) antibiotics should be started within 1 hour of the person's arrival at hospital to improve clinical outcomes, potentially reducing rates of mortality, neurological problems, hearing problems and functional impairment. Some people will have received antibiotic treatment in primary care or during ambulance transfer. Primary care services and ambulances do not have the IV antibiotics needed for bacterial meningitis or meningococcal disease. Therefore, these groups of people should also receive IV antibiotics within 1 hour of arrival at hospital.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Process

Proportion of people with suspected bacterial meningitis or suspected meningococcal disease who receive IV antibiotics within 1 hour of their arrival at hospital.

Numerator – the number in the denominator who receive IV antibiotics within 1 hour of their arrival at hospital.

Denominator – the number of people attending hospital with suspected bacterial meningitis or suspected meningococcal disease.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records. NHS England's Emergency Care Data Set includes data on suspected and confirmed bacterial meningitis and meningococcal disease. It also includes data on the urgent and emergency care start date and time.

Outcome

Mortality due to bacterial meningitis and meningococcal disease.

Data source: The Office of National Statistics collects data on mortality, including mortality due to bacterial meningitis and meningitis, and meningococcal infection.

What the quality statement means for different audiences

Service providers (secondary care services) ensure that systems are in place so that people with suspected bacterial meningitis or suspected meningococcal disease receive IV antibiotics within 1 hour of their arrival at hospital. This includes having communication channels in place to ensure medications are available when needed.

Healthcare professionals (such as emergency department nurses and doctors) ensure that people with suspected bacterial meningitis or suspected meningococcal disease receive IV antibiotics within 1 hour of their arrival at hospital.

Commissioners ensure that they commission services in which people with suspected bacterial meningitis or suspected meningococcal disease receive IV antibiotics within 1 hour of their arrival at hospital.

People with suspected bacterial meningitis or suspected meningococcal disease are given intravenous antibiotics, which are antibiotics given directly into the vein, within 1 hour of their arrival at hospital.

Definitions of terms used in this quality statement

Within 1 hour of arrival at hospital

The arrival time is the time that the person presents at the emergency department, either self-presenting or via another means such as arrival in an ambulance.

The Emergency Care Data Set states that the urgent and emergency care activity start date and time is when handover occurs, or 15 minutes after the emergency ambulance arrives at the emergency department, whichever is the sooner, and this is the 'clock start' time. This is the time that can be used for measurement purposes for this quality statement for those arriving by ambulance.

The person's booking-in time can be used for measurement purposes, if they do not arrive by ambulance. [Adapted from NHS England's Emergency Care Data Set and user guidance and expert opinion]