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.
Use in accordance with Liver Institute protocol for antifungal use at KCH
Treatment of invasive fungal infections in non-neutropenic patients with liver disease
Use in accordance with ICU antifungal guideline at GSTFT and ICU antifungal guideline (non-haem/onc) at KCH
Treatment of candidaemia and invasive disease in adult nonneutropenic ICU patients
Use in accordance with ICU antifungal guideline at LGT
Use in accordance with local antifungal guidelines for:
Treatment of invasive candidiasis in adults
Treatment of invasive aspergillosis in adults
refractory to or intolerant of amphoterocin, lipid formulations of amphoterocin B and/or itraconazole
Emperical therapy for presumed fungal infections in febrile, neutropenic adult patients who are refractory to or intolerant of amphoterocin and lipid formulations of amphoterocin
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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.
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