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 Formulary Chapter 5: Infections - Full Chapter
Notes:

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)

Chapter Links...
 Details...
05.03.01  Expand sub section  HIV infection
05.03.01  Expand sub section  Nucleoside reverse transcriptase inhibitors
05.03.01  Expand sub section  Protease inhibitors
Atazanavir (Reyataz)
(Capsule)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red Hospital
High Cost Medicine

CUH additional advice:



  • Restricted to ID / GU Medicine advice only.

  • Clinic 1A only for AIDS/HIV patients.

 
   
Darunavir (Prezista)
(Tablets, Oral suspension)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red Hospital
High Cost Medicine

CUH additional advice:



  • Restricted to ID / GU Medicine advice only.

  • Clinic 1A.

 
   
Darunavir & cobicistat (Rezolsta)
(Tablet)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red Hospital
High Cost Medicine

CUH additional advice: JDTC October 2016:



  • Clinical and funding approval granted.

  • Issues around service capacity to switch eligible patients onto more cost effective brands.

  • For now, patients can continue treatment if admitted on this but no patient's to be switched until HIV Pharmacist in post.

 
Link  CCP: Tenofovir Alafenamide for treatment of HIV 1 in adults and adolescents
   
Fosamprenavir (Telzir)
(Tablet, Oral Suspension)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red Hospital
High Cost Medicine

CUH additional advice:



  • Restricted to ID / GU Medicine advice only.

  • Restricted to Clinic 1A consultants only - funding not agreed.

 
   
Indinavir (Crixivan)
(Capsule)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red Hospital
High Cost Medicine

CUH additional advice:



  • Restricted to ID / GU Medicine advice only.

  • Clinic 1A - Treatment of HIV patients in combinaton with nucleoside analogues.

 
   
Lopinavir and Ritonavir (Kaletra)
(Tablet, Liquid)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red Hospital
High Cost Medicine

CUH additional advice:



  • Clinic 1A - for AIDS/HIV patients only (the combination helps with compliance).

 
   
Ritonavir (Norvir)
(Tablets, Oral Solution)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red Hospital
High Cost Medicine

CUH additional advice:



  • Restricted to ID / GU Medicine advice only.

  • Clinic 1a - AIDS/HIV patients in combination with nucleoside analogues.

  • Powder sachets (3 year expiry).

 
   
Saquinavir (Invirase)
(Capsule, Tablet)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red Hospital
High Cost Medicine

CUH additional advice:



  • Restricted to ID / GU Medicine advice only.

  • Treatment of HIV patients in combination with nucleoside analogues.

 
Link  MHRA safety advice (Dec 2010) : update on risk of arrhythmias - reduced dose for initial treatment
   
Tipranavir (Aptivus)
(Capsule)
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Red Hospital
High Cost Medicine

CUH additional advice:



  • Restricted to ID / GU Medicine advice only.

  • Restricted to Clinic 1A Consultant prescribing only.

 
   
05.03.01  Expand sub section  Non-nucleoside reverse transcriptase inhibitors
05.03.01  Expand sub section  Other antiretrovirals to top
05.03.01  Expand sub section  Pharmacokinetic enhancers of antiretrovirals
05.03.01  Expand sub section  Combination Products
 ....
 Non Formulary Items
Amprenavir  (Agenerase)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary
Grey

Capsule, Oral Solution

 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

OTC

Available Over the Counter. Consider Self Care   

Green

Formulary - Can be prescribed in both secondary and primary care.   

Advice

Formulary - Specialist Advice, secondary care advice provided for primary care initiation.  

Amber No SCG

Formulary - Specialist initiation without shared care guidance.  

Amber SCG

Formulary - Specialist initiation with shared care guidance.  

Red Hospital

Restricted - Hospital only, not to be prescribed in primary care.  

Switch

Not recommended for prescribing. Switch to alternative cost-effective option.   

Black

Not recommended for prescribing in primary or secondary care.  

Grey

Not recommended as no formal application made for addition to the formulary. Contact relevant pharmacy team for further information.   

Non Formulary

Non-Formulary (category under review).  

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