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 Formulary Chapter 5: Infections - Full Chapter
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05.01  Expand sub section  Antibacterial drugs
 note 
  • For full prescribing information, please see antimicrobial website
  • For information regarding restricted antibiotics, please see restricted antibiotics page within antibiotic guide
Nitrofurantoin
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Second Choice
Green
  • Second line choice, reserved for patients resistant to trimethoprim in uncomplicated UTI
  • Capsules are the preferred option
  • Tablets are reserved for enteral tube administration
  • Nitrofurantoin 25mg/5ml suspension significantly more expensive. Please refer to pharmacy for more information  
  •    
    Aztreonam (Cayston«)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    For nebulisation in Cystic Fibrosis.
    NHSE commissioned 
       
    Colistimethate sodium
    View adult BNF View SPC online  Track Changes
    Restricted Drug Restricted
    Amber SCA
    High Cost Medicine
    Colomycin« powder for reconstitution for nebulisation. Promixin« powder for nebuliser solution.
    Please ensure colistimethate is prescribed and dispensed by brand. Due to the devises they are used with, they may not be interchangeable.

    Used in bronchiectasis and cystic fibrosis. Latter is high cost drug excluded to tariff, NHSE commissioned.
    Specialist Respiratory prescribing
    See Antimicrobial website for further details  
       
    Colistimethate sodium  (Colobreathe«)
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    Restricted Drug Restricted
    Amber SCA
    High Cost Medicine
    Dry powder for inhalation, hard capsule
    For use in cystic fibrosis in line with NICE TA 276 only.
    High cost drug excluded to tariff, NHSE commissioned.
    Specialist Respiratory prescribing.

    Date of entry of decision to Formulary: April 2013
     
    Link  MHRA Advice: Colobreathe (colistimethate sodium dry powder for inhalation): risk of capsule breakageŚnew instructions for use
    Link  NICE TA 276: Colistimethate sodium and tobramycin dry powders for inhalation for treating pseudomonas lung infection in cystic fibrosis
       
    Rifaximin
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    Restricted Drug Restricted
    Amber Simple
    Specialist hepatologist initiation only for hepatic encephalopathy

    Date decision added to Formulary: June 15 
    Link  Leicestershire Guidance: Rifaximin
    Link  NICE TA 337: Rifaximin in hepatic encephalopathy
       
    Sodium fusidate (Fusidic acid)
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    Restricted Drug Restricted
    Red
    Oral and Intravenous
    See antimicrobial website.
    Restricted antibiotic, microbiology approval needed 
    Link  Antimicrobial website - Sodium fusidate
       
    Tobramycin  (Bramitob«)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Nebuliser solution for inhalation in cystic fibrosis
    High cost drug excluded to tariff, NHSE commissioned.
    Specialist Respiratory prescribing
    See Antimicrobial Website for further information. 
       
    Tobramycin  (Tobi « podhaler )
    View adult BNF View SPC online  Track Changes
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Dry powder for inhalation
    For use in cystic fibrosis in line with NICE TA 276 only.
    High cost drug excluded to tariff, NHSE commissioned.
    Specialist Respiratory prescribing

    Date of entry of decision to Formulary: April 2013
     
    Link  NICE TA 276: Colistimethate sodium and tobramycin dry powders for inhalation for treating pseudomonas lung infection in cystic fibrosis
       
     ....
     Non Formulary Items
    Ceftobiprole  (Zevtera®)

    View adult BNF View SPC online Track Changes
    Non Formulary
    Black

    Hospital and community-acquired pneumonia in adults.

     
    Doxycycline 40mg M/R  (Efracea«)

    View adult BNF View SPC online Track Changes
    Non Formulary
    Black
    Link  Leicestershire Evaluation: Efracea in Rosacea
     
      
    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 children's BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    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

    Black

    Drugs not recommended for use in the Leicestershire Health Community because of lack of evidence of clinical effectiveness, cost prioritization or concerns over safety. All new drugs will be black until they have been through the appropriate approval process - then they will appear as a specific entry   

    Red

    Drugs which should be prescribed only by hospital specialists (clinical review by specialist as appropriate and annually as a minimum).  

    Amber SCA

    Drugs which would initially be prescribed by a hospital specialist and then by a GP where full agreement to share the care of each specific patient has been reached under a LMSG Shared Care Agreement (SCA). Specific patient monitoring or intervention required.   

    Amber Simple

    Drugs suitable to be initiated and prescribed in primary care only after specialist assessment and recommendation. A shared care agreement is not required.  

    Green Conditional

    Drugs for which GPs are able to take full responsibility for prescribing and monitoring subject to specified conditions e.g. prescribing in line with agreed LMSG guidance or able to demonstrate suitable competence see comments under individual entries.   

    Green

    Drugs for which GPs would normally take full responsibility for prescribing and monitoring. Drugs included in this list have been specifically considered by LMSG.   

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