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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:
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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05.03.03.01  Expand sub section  Chronic hepatitis B
Adefovir dipivoxil tablets

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High Cost Medicine
Red

Link  NICE CG165: Hepatitis B (chronic) - incorporates TA96
Link  NICE TA96: Hepatitis B (chronic) - adefovir dipivoxil and pegylated interferon alpha-2a    
Entecavir tabs, oral solution

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Link  NICE CG165: Hepatitis B (incorporates TA153)
Link  NICE TA153: Hepatitis B (chronic) - etecavir    
Lamivudine tabs, oral solution

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Red

Link  NICE CG165: Hepatitis B    
Peginterferon alfa-2a injection

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Red

Link  NICE TA96: Adefovir and peginterferon alfa-2a for the treatment of chronic hepatitis B    
Tenofovir disoproxil tabs

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Red
Use in accordance with local guidelines:
  • First line for chronic hepatitis B
  • An option for substitution for adefovir in those
    patients on combination lamivudine/adefovir
  • Add-on in those patients with suboptimal response/resistance to lamivudine or entecavir

  • Link  NICE TA173: Tenofovir disoproxil for the treatment of chronic hepatitis B    
     ....
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    High Cost Medicine
    High Cost Medicine
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    Traffic Light Status Information

    Status Description
      Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. 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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