netFormulary NHS
Cambridgeshire and Peterborough
 Formulary Chapter 5: Infections - Full Section


COVID-19: guidance for health professionals 


Intravenous antibiotics are more expensive than oral equivalents and some are very expensive they also put patients at risk of IV cannula infections. Oral antibiotics are usually fairly cheap. IM injections are rarely if ever indicated.

Course lengths:
Prescriptions for oral antibiotics for in-patients should be reviewed at or before five days. Prescriptions for intravenous antibiotics should be reviewed at or before 48 hours after which the patient should be considered for an oral antibiotic if there is an equivalent available. For uncomplicated urinary tract infections three days treatment is usually sufficient in adult women. Complicated infections require longer treatment.

When initiating therapy with agents marked with Restricted, you must seek Microbiology/Infectious Diseases advice.

The restricted antimicrobials may be prescribed without discussion with microbiology if they are being used for an approved indication as specified. Use outside these indications (and any use for some antimicrobials) requires DOCUMENTED approval from one of the medical microbiologists or Infectious Diseases Physician prior to prescribing.

For further information on prescribing antimicrobials at Royal Papworth Hospital please refer to the Microguide

Prescribing in Primary Care and CPFT should follow the Primary Care Prescribing Guidelines and initiate only those treatments recommended as Green (unless on the advice of a microbiologist).

Use in pregnancy

  • It is important to ensure adequate treatment of maternal infection in pregnancy as failure to treat may lead to adverse maternal and fetal outcome as a consequence of uncontrolled infection or fever.
  • When considering treatment with antibacterial agents during pregnancy, the following factors should be taken into account: the severity of the maternal infection, the presence of fever, the maternal and fetal risks associated with failing to treat the mother adequately, the pharmacokinetic and pharmacodynamic effects (where known) of pregnancy on drug absorption, distribution, metabolism and excretion, and the potential fetotoxicity of the treatments being considered.
  • Where possible, antibiotic choice should be informed by culture and sensitivity tests, however if treatment is required urgently or before test results become available, then penicillins or cephalosporins should be considered where clinically appropriate.
  • See UKTIS Antibiotic use in Pregnancy for further information. 
  • Prescribing in Primary Care and CPFT should follow the Primary Care Prescribing Guidelines which includes specific guidance for pregnancy and initiate only those treatments recommended as Green (unless on the advice of a microbiologist).
 Useful Links
Numbers in brackets indicate counts of (Formulary items, Non Formulary items)
05.01 Antibacterial drugs (0,1)
05.01.01 Penicillins (0,0) Benzylpenicillin and phenoxymethylpenicillin (2,0) Penicillinase-resistant penicillins (3,0) Broad-spectrum penicillins (4,2) Antipseudomonal penicillins (2,0) Mecillinams (1,0)
05.01.02 Cephalosporins, carbapenems and other beta-lactums (0,0) Cephalosporins (8,4) Carbapenems (2,0) Other beta-lactums antibiotics (2,0)
05.01.03 Tetracyclines (5,2)
Tigecycline (1,0)
05.01.04 Aminoglycosides (7,0)
05.01.05 Macrolides (5,1)
05.01.06 Clindamycin (1,0)
05.01.07 Some other antibacterials (2,2)
Chloramphenicol (2,0)
Fosfomycin (1,0)
Fusidic acid (1,0)
Vancomycin and teicoplanin (3,0)
Daptomycin (1,0)
Linezolid (1,0)
Polymyxins (4,0)
Rifaximin (1,0)
Fidaxomicin (1,0)
05.01.08 Sulphonamides and trimethoprim (3,0)
05.01.09 Antituberculosis drugs (14,1)
05.01.10 Antileprotic drugs (2,0)
05.01.11 Metronidazole and tinidazole (2,1)
05.01.12 Quinolones (7,2)
05.01.13 Urinary-tract infections (3,1)
05.02 Antifungal drugs (12,1)
05.02.01 Triazole antifungals (0,0)
05.02.02 Imidazole antifungals (0,0)
05.02.03 Polyene antifungals (0,0)
05.02.04 Echinocandin antifungals (3,0)
05.02.05 Other antifungals (0,0)
05.03 Antiviral drugs (0,0)
05.03.01 HIV infection (1,3)
Nucleoside reverse transcriptase inhibitors (16,0)
Protease inhibitors (9,1)
Non-nucleoside reverse transcriptase inhibitors (3,0)
Other antiretrovirals (5,0)
Pharmacokinetic enhancers of antiretrovirals (0,0)
Combination Products (1,0)
05.03.02 Herpesvirus infections (0,0) Herpes simplex and varicella-zoster infection (4,0) Cytomegalovirus infection (6,0)
05.03.03 Viral hepatitis (0,0) Chronic hepatitis B (1,1) Chronic hepatitis C (10,1)
05.03.04 Influenza (3,2)
05.03.05 Respiratory syncytial virus (3,0)
05.04 Antiprotozoal drugs (1,0)
05.04.01 Antimalarials (0,0)
Artemether with lumefabtrine (1,0)
Chloroquine (1,0)
Mefloquine (1,0)
Primaquine (1,0)
Proguanil (1,2)
Pyrimethamine (2,0)
Quinine (1,0)
05.04.02 Amoebicides (2,0)
05.04.03 Trichomonacides (1,0)
05.04.04 Antigiardial drugs (2,0)
05.04.05 Leishmaniacides (1,0)
05.04.06 Trypanocides (0,0)
05.04.07 Drugs for toxoplasmosis (1,0)
05.04.08 Drugs for pneumocystis pneumonia (3,1)
05.05 Anthelmintics (2,0)
05.05.01 Drugs for threadworms (2,0)
05.05.02 Ascaricides (0,0)
05.05.03 Drugs for tapeworm infections (1,1)
05.05.04 Drugs for hookworms (0,0)
05.05.05 Schistosomicides (0,0)
05.05.06 Filaricides (0,0)
05.05.07 Drugs for cutaneous larva migrans (0,1)
05.05.08 Drugs for strongyloidiasis (0,0)