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
 
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 Formulary Chapter 12: Ear, nose and oropharynx - Full Chapter
12.02.03  Expand sub section  Nasal preparations for infection
12.02.03  Expand sub section  Nasal Staphylococci
Bismuth subnitrate & iodoform gauze
Formulary  
   
Chloramphenicol 1% eye ointment  (ENT post surgery - off-label)
View adult BNF View SPC online
Formulary Approved off-label indication: Topical use post open rhinoplasty. Applied twice daily for a short course post-procedure 
   
Mupirocin 2% nasal ointment
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Formulary USE ON MICROBIOLOGY/VIROLOGY ADVICE 
   
Naseptin cream
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Formulary USE ON MICROBIOLOGY/VIROLOGY ADVICE Contains:
  • Chlorhexidine hydrochloride 0.1%
  • Neomycin sulphate 0.5% Caution: also contains arachis oil (peanut oil) 
  •    
    Octenidine nasal gel
    Formulary
    Red
    USE ON MICROBIOLOGY/VIROLOGY ADVICE 
       
    Polyfax eye ointment
    View adult BNF
    Restricted Drug Restricted USE ON MICROBIOLOGY/VIROLOGY ADVICE only - for eradication of nasal carriage of MRSA Contains:
  • Polymixin B sulphate 10 000units/g
  • Bacitaricin zinc 500 units/g Instructions:
  • Eye ointment is used in the nose
  • A matchhead size portion to be applied into each nostril
  • Close nostrils to spread the ointment throughout the nares
  • Dose = 2-3 times daily
  • Continue treatment for 5-7 days  
  •    
    Alkaline nasal douche
    Unlicensed Drug Unlicensed Powder containing:
  • Sodium bicarbonate 20g
  • Sodium chloride 20g
  • Borax 20g Indications:
  • Post-operatively after nasal surgery and functional endoscopic sinus surgery.
  • For any condition causing crusting of nasal cavities Instructions for use:
  • 5 mL spoonful of powder added to a tumblerful of warm water and mixed well.
  • Small aliquots of the solution are sniffed.
  • Any solution that goes into the throat should not be swallowed
  • Dose = three times daily  
  •    
     ....
    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
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    Link to adult BNF
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    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

    Red

    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  

    Green

    Specialist and non-specialist initiation  

    Grey

    Not recommended for prescribing  

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