netFormulary NHS
NHS Bath and North East Somerset, Swindon and Wiltshire CCG
Royal United Hospitals Bath NHS Foundation Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
 Search
 Formulary Chapter 5: Infections - Full Chapter
Notes:

Only high cost medicines to be supplied within our health economy are listed on BSW Formulary, but patients may also have access to more specialised, high cost medicines via other specialist centres, if eligible.

 

Infections Prescribing Guidance 

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

The Primary care antibiotic guidance can be found here

Management of Infection Quick Ref Guide for Adults can be found here

Management of Infection Quick Ref Guide for Children can be found here

Infections-related Shared Care Agreements

Please see our Shared Care Agreements page for all shared care agreements (SCAs) relating to this chapter

Lyme Disease:

Most up to date information see NICE Guideline NG95  April 2018 and for treatment regimens please see our primary care antibiotic guidance (link above).

Th NICE guideline covers diagnosing and managing Lyme disease. It aims to raise awareness of when Lyme disease should be suspected and ensure that people have prompt and consistent diagnosis and treatment. It does not cover preventing Lyme disease.

For general information www.lymediseaseaction.org.uk/resources/guidelines/ 

Out-patient Antibiotic Therapy (OPAT) services across BaNES/Swindon/Wiltshire:

GWH OPAT service:

OPAT Specialist Nurse - 01793 605032

Or alternatively contact switchboard on 01793 604020 and bleep 1108

OPAT Team working hours:

Monday to Friday 08:30am – 16:30pm

Out of hours contact:

Switchboard – 01793 604020 and bleep:

On call Orthopaedic registrar – 1088

On call Medical registrar – 3333

Other useful contact telephone numbers:

The PICC Team – 01793 605885 or bleep 2615

SEQOL – Swindon Community Nurses – 01793 646466

RUH OPAT service:

Direct line (with answerphone): 01225 821490

OR RUH switchboard and bleep 7467

Service is open Monday to Friday 8am to 4-4:30pm

NHSE Easy read information: Sepsis These easy read documents provide information about how to avoid sepsis, spotting the signs of sepsis, and problems after sepsis. 4/3/2020

Self-care

Many of the products in this chapter are available for purchase over-the-counter, and patients are encouraged to self-care, with the support of their community pharmacist, in the first instance.

For further information on self-care & the NHS, please refer to https://www.england.nhs.uk/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/

Chapter Links...
 Details...
05.01.07  Expand sub section  Some other antibacterials
Dalbavancin
View adult BNF View SPC online
Formulary
traffic lightRed
  • 500mg powder for concentrate for solution for infusion vials

 

 
 
Rifaximin
(Tablet)
View adult BNF View SPC online
Formulary
traffic lightAmber with Shared Care
  • Tablets 550mg
  • All non-NICE indications require an IFR to the CCG.
  • NOTE: Rifaximin 200mg (Xifaxanta®) is NON-FORMULARY, including use for travellers diarrhoea and should not be prescribed on FP10.

 

 
Link  3Ts Rifaximin Shared Care Document
Link  BCAP Rifaximin Shared Care Document
Link  NICE TA337: Rifaximin for preventing episodes of overt hepatic encephalopathy (March 2015)
Link  SFT Rifaximin Shared Care Document
 
Pristinamycin
View adult BNF View SPC online
Unlicensed Drug Unlicensed
traffic lightRed
  • RUH only: For bone and joint infections following microbiology recommendation only.
  • Not on formulary at GWH or SFT
 
 
05.01.07  Expand sub section  Chloramphenicol
Chloramphenicol
( Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  •  1g injection
 
 
05.01.07  Expand sub section  Fosfomycin
Fosfomycin
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • For use on consultant microbiologist advice only
  • 2g powder for solution for infusion vials
  • 4g powder for solution for infusion vials 
  • EMA has recommended that fosfomycin medicines given by infusion (drip) into a vein should only be used to treat serious infections when other antibiotic treatments are not suitable. 27/3/2020    
 
Link  CHMP Fosfomycin-containing medicinal products: Recommendations to restrict use of fosfomycin antibiotics​
 
05.01.07  Expand sub section  Fusidic acid
Sodium fusidate oral
(Fusidic acid )
(Oral)
Formulary
traffic lightAmber
  • Tablets 250mg
  • Fusidic acid oral suspension 250mg/5ml (5ml is approx. equivalent to 175mg sodium fusidate).
  • On advice of Consultant Microbiologist when prescribed in primary care

 

 
 
05.01.07  Expand sub section  Vancomycin and teicoplanin to top
Teicoplanin
(Injection)
View adult BNF View SPC online
Formulary
  • Red 
  • Green only for use by BaNES community nurse team.
  • 200mg
  • 400mg
 
 
Vancomycin
(Capsule)
View adult BNF View SPC online
Formulary
traffic lightGreen
  • 125mg
  • 250mg
  • Only for treatment of Clostridium Difficile associated diarrhoea.
 
 
Vancomycin
(Injection )
View adult BNF View SPC online
Formulary
traffic lightRed
  • 500mg
  • 1g.
  • Blood level monitoring is mandatory for IV use.
 
 
05.01.07  Expand sub section  Daptomycin
Daptomycin
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • Use with microbiology advice only
  • GWH/RUH only
 
 
05.01.07  Expand sub section  Linezolid
Linezolid
(Oral, infusion)
View adult BNF View SPC online
Formulary
traffic lightRed
  • Tablets 600mg
  • IV infusion 600mg/300ml
  • FBC monitoring (including platelets) should be performed weekly.
 
 
05.01.07  Expand sub section  Quinupristin and dalfopristin
05.01.07  Expand sub section  Polymyxins
Colistimethate
( Injection )
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
CCG
  • Red RUH CF patients (seen at BRI hospital) TLS Red for management of acute and chronic CF infections 
     
  • Amber with Shared Care RUH only: Nebulised- NON-CF patients chronically colonised with P.aeruginosa Prescribe as Colomycin® brand along with sodium chloride ampoules for reconstitution as detailed in SCA (below)

  • Amber GWH for use in bronchiectasis and existing CF patients (usually nebulised).
  • Red  GWH for use in new CF patients (usually nebulised).
  • Red GWH use IV for treatment of carbapenemase-producing Enterobacteriaceae

  • 500,000 units
  • 1 million units
  • 2 million units

 

 
Link  BCAP SCA - nebulised colistimethate Non-CF bronchiectasis
 
Colistimethate
(Colobreathe)
(Inhaler)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  •  Dry powder for inhaler and hard capsule 1.66 million units/capsule
 
Link  Clinical Commissioning Policy: Inhaled Therapy for Adults and Children with Cystic Fibrosis NHS England A01/P/b
Link  Colobreathe (colistimethate sodium dry powder for inhalation): risk of capsule breakage - new instructions for use
Link  NICE TA276: Cystic fibrosis (pseudomonas lung infection) - colistimethate sodium and tobramycin
 
05.01.07  Expand sub section  Rifaximin to top
05.01.07  Expand sub section  Fidaxomicin
Fidaxomicin
(Tablet)
View adult BNF View SPC online
Formulary
traffic lightAmber
  • Tablets 200mg
  • For the treatment of intractable Clostridium Difficile on microbiologist
    advice only.
  • See local primary care antibiotic guidance for treatment advice in
    primary care or acute trust guidance for treatment in secondary care setting.
    See PHE management and treatment of Clostridium guidance on link below.
 
Link  PHE Clostridium difficile: guidance, data and analysis Sept 2019
 
 ....
 Non Formulary Items
Bezlotuxumab (Zinplava)

View adult BNF View SPC online
Non Formulary
 
Oritavancin (Orbactiv)

View adult BNF View SPC online
Non Formulary
 
Quinupristin and dalfopristin
(Synercid®)

View adult BNF View SPC online
Non Formulary
 
Rifaximin (Targaxan)
(Encephalopathy)

View adult BNF View SPC online
Non Formulary
 
Sodium fusidate
(Fucidin®)

View adult BNF View SPC online
Non Formulary
 
Tedizolid (Sivextro)

View adult BNF View SPC online
Non Formulary
 
  
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
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Traffic LightRed

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Traffic LightAmber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Traffic LightAmber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Traffic LightGreen

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Traffic LightSelf

Suitable for patient to be directed to buy themselves  

Traffic LightGrey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Traffic LightBlack

(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.   

Traffic LightRed Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.  

netFormulary