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 5: Infections - Full Chapter
Notes:
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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05.02.04  Expand sub section  Echinocandin antifungals
Anidulafungin injection
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Red
High Cost Medicine
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 
   
Caspofungin injection
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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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    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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