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.
At GSTFT, use in accordance with the guideline “Management of Malaria in Adults”
First-line therapy for severe falciparum malaria in non-pregnant adults
Artemether with lumefabtrine
Artemether with lumefantrine tabs (Riamet®)
Chloroquine tabs, syrup, injection
Prevention of subsequent relapse of non-falciparum malaria
Dose: Orally 15 mg daily for 14 days following the treatment of P. vivax and P. ovale malaria.
Please seek expert advice for G6PD deficient individuals and cases where relapse occurs despite primaquine therapy
PCP treatment in accordance with BHIVA guidelines
Dose: 15-30 mg once daily
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