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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.

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 Details...
05.01.04  Expand sub section  Aminoglycosides
Amikacin injection
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Formulary
Red
 
   
Gentamicin injection
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Red
 
   
Gentamicin injection (off-label intratympanic use in ENT surgery)
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Red

Approved off-label indication:

Intra-tympanic injection in unilateral vestibular failure (e.g. Meniere’s Disease, Vestibular Schwannoma).

Dose: 60 mg to 80 mg gentamicin buffered with 0.5 mL of sodium bicarbonate 8.4% to fill the middle ear

This procedure is repeated again (at least two hours apart) on the same day. Pretreatment vestibular function testing (caloric testing) must be performed to ensure a normally functioning contralateral labyrinth

 
   
Gentamicin injection (off-label use for soaking penile implants)
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Red

Approved off-label indication:

For soaking penile implants, in combination with rifampicin, before insertion

Rifampicin 10 mg/ml and gentamicin 1.2 mg/ml solution made from using 50ml sodium chloride 0.9%, rifampicin 600 mg injection and gentamicin 80 mg injection

 
   
Gentamicin injection (off-label use in pacemaker surgery)
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Red

Approved off-label indication:

Topical use into the pocket during pacemaker surgery

 
   
Neomycin tabs
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Netilmicin injection
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Formulary
Red
 
   
Tobramycin injection
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Red
 
   
Tobramycin nebuliser solution
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Formulary
Red
High Cost Medicine

 
Link  SE London APC Shared Care Agreement: Nebulised mucolytic and antibiotic solutions for treatment of Cystic Fibrosis in existing paediatric patients
   
Tobramycin dry powder for inhalation  (Tobi Podhaler)
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Red
High Cost Medicine
 
Link  NICE TA276: Colistimethate sodium and tobramycin dry powders for inhalation for treating pseudomonas lung infection in cystic fibrosis
   
 ....
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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