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Royal United Hospitals Bath NHS Foundation Trust
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 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...
05.03.01  Expand sub section  HIV infection
 note 

Refer to British HIV Guidelines at http://www.bhiva.org/

For information on drug interactions see the Liverpool University site at http://www.hiv-druginteractions.org/

05.03.01  Expand sub section  Nucleoside reverse transcriptase inhibitors
Abacavir 
(Oral)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  • Tablets 300mg
  • Oral solution 20mg/ml
 
   
Abacavir and Lamivudine
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  •  600 mg of abacavir (as sulfate) and 300 mg lamivudine
 
   
Bictegravir, Emtricitabine, Tenofovir alafenamide
(Biktarvy®)
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  • Tablets containing bictegravir sodium equivalent to 50 mg of bictegravir, 200 mg of emtricitabine, and tenofovir alafenamide fumarate equivalent to 25 mg of tenofovir alafenamide
  • For treatment of HIV-1 in adults in line with NHSE CCP
 
   
Dolutegravir, abacavir & lamivudine
(Triumeq®)
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  • 50 mg dolutegravir (as sodium), 600 mg of abacavir (as sulfate) and 300 mg of lamivudine
 
Link  MHRA safety update June 2018: Dolutegravir (Tivicay¥, Triumeq¥, Juluca¥): signal of increased risk of neural tube defects
   
Emtricitabine (Emtriva®)
(Oral)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  • Capsules 200mg
  • Oral solution 50mg/5ml
 
   
Emtricitabine + tenofovir alafenamide
(Descovy®)
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  •  Emtricitabine/Tenofovir alafenamide 200mg/10mg or 200mg/25mg 
 
   
Emtricitabine 200mg, Rilpivirine 25mg and Tenofovir 245mg
(Eviplera®)
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  •  Emtriciciabine 200mg, rilpivirine 25mg, tenofovir 245mg
 
   
Emtricitabine, rilpivirine, & tenofovir alafenamide
(Odefsey ®)
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  •  Rilpivirine 25mg, emtricitabine 200mg tenofovir alafenamide (TAF) 25mg
 
   
Tenofovir 245mg, Efavirenz 600mg and Emtricitabine 200mg
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  •  Prescribe generically.
  •  Efavirenz 600mg, emtricitabine 200mg, tenofovir disoproxil 245mg
 
   
Tenofovir alafenamide, elvitegravir, cobicistat & emtricitabine
(Genvoya®)
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  • Elvitegravir 150mg, cobicistat 150mg, emtricitabine 200mg, tenofovir alafenamide fumerate 10mg
 
Link  MHRA Drug Safety Update (Apr 2019): Elvitegravir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1
Link  Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects Dec 16
   
Tenofovir and Emtricitabine
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  •  Prescribe generically.
  •  Tenofovir disoproxil 245mg and emtricitabine 200mg
 
   
Tenofovir Disproxil
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  •  245mg
 
Link  NICE TA173: Hepatitis B (chronic) - tenofovir disoproxil
   
Tenofovir, cobicistat, darunavir & emtricitabine
(Symtuza)
(Tablet)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  • Each film-coated tablet contains 800 mg of darunavir (as ethanolate), 150 mg of cobicistat, 200 mg of emtricitabine, and 10 mg of tenofovir alafenamide (as fumarate).

 

 
   
Tenofovir, cobicistat, elvitegravir & emtricitabine
(Stribild®)
(Tablet )
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  • Eivitegravir 150mg, cobicistat 150mg, emtricitabine 200mg and 245 mg of tenofovir disoproxil (equivalent to 300 mg of tenofovir disoproxil fumarate or 136 mg of tenofovir).
 
Link  MHRA Drug Safety Update (Apr 2019): Elvitegravir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1
Link  MHRA safety warning Dec 2016: Cobicistat, ritonavir and coadministration with a steroid: risk of systemic corticosteroid adverse effects
   
Zidovudine 
(Oral)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  • Capsules 100mg, 250mg
  • Oral solution 50mg/5ml
 
   
Zidovudine 
(IV Injection)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  •  10mg/ml, 20ml vial
 
   
Zidovudine and Lamivudine

(Tablets )
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England
  • Lamivudine 150mg and zidovudine 300mg
  • Prescribe generically
 
   
05.03.01  Expand sub section  Protease inhibitors
05.03.01  Expand sub section  Non-nucleoside reverse transcriptase inhibitors
05.03.01  Expand sub section  Other antiretrovirals to top
 ....
 Non Formulary Items
Stavudine 

View adult BNF View SPC online
Non Formulary
High Cost Medicine
 
  
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

Red

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

Amber

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

Amber 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.  

Green

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

Self

Suitable for patient to be directed to buy themselves  

Grey

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

Black

Not currently used. We intend to include this TLS in future to highlight where a decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.  

Red 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.  

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