netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 Formulary Chapter 5: Infections - Full Chapter

Where a formulary entry does not detail a medicine’s indications for use, the medicine can be assumed to be approved for all licensed indications.

Formulary approved "off-label" use is detailed separately.

This section advises on the choice of anti-infective agents available at each Trust.  Doctors should refer to local or departmental antibiotic  guidelines for advice regarding specific treatments within specialised  units (including prophylaxis for surgical, medical and dental  procedures). Different antibiotic policies can be found in different  hospitals due to local variations in resistance and antibiotic  susceptibility.

M: Use of this agent only to be initiated under the advice of a  microbiologist or virologist as appropriate.

S: Use of this agent only to be initiated under the advice of a relevant clinical specialist.

05.01.13  Expand sub section  Urinary-tract infections
Methenamine hippurate tabs
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Can be considered third line use for prevention of recurrent UTI in non-pregnant women (if no renal or hepatic impairment) after simple measures for symptom relief and stand-by or post-coital antibiotics have been ineffective.

Refer to local antimicrobial guidance

Nitrofurantoin tabs, caps, mr caps, oral suspension
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Uro-Vaxom capsules  (lyophilized bacterial extract from 18 strain of E-coli)
Unlicensed Drug Unlicensed

Approved for the prophylaxis of uncomplicated recurrent UTI

Dose = 6 mg daily for 3 months

Restricted to:

  • Failure of least one 3 month course of oral prophylactic antimicrobials
  • Failure of at least one 3 month course of methenamine hippurate (if suitable)
  • More than two urinary tract infections in the past six months
  • Culture proven growth within the last three months of Escherichia coli
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
Track Changes
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Link to SPCs
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHS England

Traffic Light Status Information

Status Description


Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   

Amber 1

Treatment can be initiated in primary care after a recommendation from an appropriate specialist  

Amber 2

Specialist initiation followed by maintenance prescribing in primary care  

Amber 3

Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  


Specialist and non-specialist initiation  


Not recommended for prescribing