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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...
05.01.09  Expand sub section  Antituberculosis drugs
Rifampicin caps, syrup
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Formulary

Red Traffic Light For treatment of tuberculosis

Amber Traffic Light For treatment of non-tuberculosis infections

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

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

 
   
Aminosalicylic acid granules (Granupas gastro-resistant granules 4g sachets)
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Restricted Drug Restricted
Red

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 

 
   
Bedaquiline tabs (Sirturo)
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Formulary
Red
High Cost Medicine
BlueTeq

Specialist TB respiratory consultant use only

Approved for use in accordance with NHS England Clinical Commissioning Policy F04/P/a

 
Link  NHS England F04/P/a: Bedaquiline and Delamanid for defined patients with MDR-TB and XDR-TB
   
Cycloserine caps
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Restricted Drug Restricted
Red

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 

 
   
Delamanid tabs (Deltyba)
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Formulary
Red
High Cost Medicine
BlueTeq

Specialist TB respiratory consultant use only

Approved for use in accordance with NHS England Clinical Commissioning Policy F04/P/a

 
Link  NHS England F04/P/a: Bedaquiline and Delamanid for defined patients with MDR-TB and XDR-TB
   
Ethambutol injection
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Formulary
Red

Approved for use in place of ethambutol tabs for treatment of tuberculosis; only if the oral route is not available or appropriate.

 
   
Ethambutol tabs
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Formulary
Red
 
   
Isoniazid tabs, injection
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Formulary
Red

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

 

 
   
Pyrazinamide tabs
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Formulary
Red
Treatment of tuberculosis in combination with other drugs 
   
Rifabutin caps
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Formulary
Red
 
   
Rifater tabs
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Formulary
Red
Each tablet contains:
  • Rifampicin 120 mg
  • Isoniazid 150 mg
  • Pyrazinamide 300 mg 
  •    
    Rifinah 150/100 tabs
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    Formulary
    Red
    Each tablet contains:
  • Rifampicin 150 mg
  • Isoniazid 100 mg  
  •    
    Rifinah 300/150 tabs
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    Formulary
    Red
    Each tablet contains:
  • Rifampicin 300 mg
  • Isoniazid 150 mg  
  •    
    Azithromycin tabs
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    Formulary
    Red

    Approved off-label indication:

    Treatment of tuberculosis in HIV patients

     
       
    Ethambutol 400mg in 5mL suspension
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    Unlicensed Drug Unlicensed
    Red

     
       
    Isoniazid 50 mg in 5mL elixir
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    Unlicensed Drug Unlicensed
    Red

     

     
       
    Protionamide tabs, injection
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    Unlicensed Drug Unlicensed
    Red
    Drug resistant tuberculosis 
       
    Pyrazinamide 500 mg in 5mL suspension
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    Unlicensed Drug Unlicensed
    Red

    Treatment of tuberculosis in combination with other drugs

     
       
    Streptomycin injection
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    Unlicensed Drug Unlicensed
    Red
    Treatment of tuberculosis in combination with other drugs 
       
     ....
    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
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    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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