South East London Joint Medicines Formulary Formulary

	South East London Joint Medicines Formulary
	Guy's and St Thomas' NHS Foundation Trust Kings College Hospital NHS Foundation Trust Lewisham and Greenwich NHS Trust

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Formulary Chapter 5: Infections - Full Chapter

Notes:

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.

Details...

05.01.13

Urinary-tract infections

Methenamine hippurate tabs

Formulary

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

Formulary

Uro-Vaxom capsules (lyophilized bacterial extract from 18 strain of E-coli)

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

NICE CG97: Lower urinary tract symptoms in Men

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Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG

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.
	Treatment can be initiated in primary care after a recommendation from an appropriate specialist
	Specialist initiation followed by maintenance prescribing in primary care
	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