Microbiology

The Microbiology service is based at Maidstone Hospital, providing a comprehensive clinical service to hospitals in the trust, the ICB and the community.

Some specialist investigations are provided through arrangements with specialised laboratories throughout the UK.

There is 24 hour support 365 days a year on both sites for urgent patient management.

The department is assessed by the National Pathology accreditation body United Kingdom Accreditation Service (UKAS) against ISO 15189:2022 standards.

Antimicrobial guidelines and antibiotic levels

See the Kent and Medway Joint Medicines Formulary for treatment of infectious diseases.

Gentamicin and Vancomycin levels are now performed by Clinical Biochemistry.

Results are available on PAS (if requested via PAS) as soon as authorised. For other antibiotic levels, discuss with the microbiology consultant.

Gentamicin

  • A trough (pre-dose) level is required 18-24 hours after the first dose
  • It is not necessary to take a post dose level for once daily dosing. Only take a post dose level on patients on bd or tds gentamicin
  • The trough (pre-dose) level should be less than 1mg/L
  • The post dose level (if done) should be 5-10mg/l
  • If gentamicin levels are within range and renal function is stable, monitor gentamicin levels every 2 to 3 days.

Vancomycin

  • A trough (pre-dose) level is required immediately before the third dose.
  • Post-dose levels are not required.
  • Trough (pre-dose) level should be 15-20mg/L
  • If trough (pre-dose) level is outside reference range seek advice from Microbiology. After each dose adjustment re-check level before third dose on the new regimen.
  • If levels are within range and renal function is stable, twice weekly monitoring of pre-dose (trough) level is recommended.

Out of hours service

Scientific staff provide an on call service to process urgent samples. Unauthorised results from routine samples are not available. Authorised results are available via the web browser.

Microbiology consultant staff provide an on call clinical advisory service.

Details of these services and contact details is in Microbiology out of hours service [pdf] 230KB