| Formulary Chapter 5: Infections - Full Chapter
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| 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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| Chapter Links... |
 NICE CG54: Urinary tract infection in under 16s: diagnosis and management |
| NICE NG138: Pneumonia (community-acquired): antimicrobial prescribing |
| NICE NG139: neumonia (hospital-acquired): antimicrobial prescribing |
| NICE NG141: Cellulitis and erysipelas: antimicrobial prescribing |
| NICE NG84: Sore throat (acute): antimicrobial prescribing |
| NICE NG89: Sinusitis (acute): antimicrobial prescribing |
| NICE NG91: Otitis media (acute): antimicrobial prescribing |
| Details... |
| 05.01.09 |
Antituberculosis drugs |
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Rifampicin caps, syrup
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Formulary
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    For treatment of tuberculosis
 For treatment of non-tuberculosis infections
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Rifampicin injection
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Formulary
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Rifampicin injection (off-label use for soaking penile implants)
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Formulary
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   Approved off-label indication:
For soaking penile implants, in combination with gentamicin 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
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Aminosalicylic acid granules (Granupas gastro-resistant granules 4g sachets)
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 Restricted
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Approved for use in multi-drug resistant tuberculosis (MDR-TB) on specialist microbiology or specialist TB recommendation only, as per recommendations from the World Health Organisation
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Bedaquiline tabs (Sirturo®)
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Formulary
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  Specialist TB respiratory consultant use only
Approved for use in accordance with NHS England Clinical Commissioning Policy Statement 170132P
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NHS England 170132P: Treatment for defined patients with MDR-TB and XDR-TB including bedaquiline and delamanid
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Clofazimine caps
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Restricted
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Approved for use in multi-drug resistant tuberculosis (MDR-TB) on specialist microbiology or specialist TB recommendation only, as per recommendations from the World Health Organisation
(unlicensed import)
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Cycloserine caps
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Restricted
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Approved for use in multi-drug resistant tuberculosis (MDR-TB) on specialist microbiology or specialist TB recommendation only, as per recommendations from the World Health Organisation
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Delamanid tabs (Deltyba®)
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Formulary
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Specialist TB respiratory consultant use only
Approved for use in accordance with NHS England Clinical Commissioning Policy Statement 170132P
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NHS England 170132P: Treatment for defined patients with MDR-TB and XDR-TB including bedaquiline and delamanid
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Ethambutol injection
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Formulary
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Approved for use in place of ethambutol tabs for treatment of tuberculosis; only if the oral route is not available or appropriate.
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Ethambutol tabs
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Formulary
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Isoniazid tabs, injection
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Formulary
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Approved for licensed use and the following off-label indication:
Tuberculosis prophylaxis in kidney or pancreas transplant recipients
Dose = 300 mg daily for 6 months together with pyridoxine 25 mg daily
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Linezolid tabs, suspension, injection
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Restricted
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Approved off-label indication:
Use in multi-drug resistant tuberculosis (MDR-TB) on specialist microbiology or specialist TB recommendation only, as per recommendations from the World Health Organisation
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Moxifloxacin tabs, injection
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Restricted
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Approved off-label indication:
Use in multi-drug resistant tuberculosis (MDR-TB) on specialist microbiology or specialist TB recommendation only, as per recommendations from the World Health Organisation
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Pyrazinamide tabs
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Formulary
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 Treatment of tuberculosis in combination with other drugs
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Rifabutin caps
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Formulary
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Rifater® tabs
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Formulary
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Each tablet contains:
Rifampicin 120 mg
Isoniazid 150 mg
Pyrazinamide 300 mg
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Rifinah® 150/100 tabs
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Formulary
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Each tablet contains:
Rifampicin 150 mg
Isoniazid 100 mg
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Rifinah® 300/150 tabs
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Formulary
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Each tablet contains:
Rifampicin 300 mg
Isoniazid 150 mg
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Azithromycin tabs (tuberculosis)
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Formulary
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 Approved off-label indication:
Treatment of tuberculosis in HIV patients
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Ethambutol 400mg in 5mL suspension
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 Unlicensed
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Isoniazid 50 mg in 5mL elixir
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Unlicensed
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Protionamide tabs, injection
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Unlicensed
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 Drug resistant tuberculosis
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Pyrazinamide 500 mg in 5mL suspension
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Unlicensed
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Treatment of tuberculosis in combination with other drugs
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Streptomycin injection
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Unlicensed
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Treatment of tuberculosis in combination with other drugs
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
| Status |
Description |
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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.
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Treatment can be initiated in primary care after a recommendation from an appropriate specialist |
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Specialist initiation followed by maintenance prescribing in primary care |
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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 |
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Specialist and non-specialist initiation |
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Not recommended for prescribing |
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