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Bedfordshire and Luton Joint Formulary
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Bedfordshire CCG
Luton & Dunstable University Hospital NHS Foundation Trust
Luton CCG
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 Formulary Chapter 5: Infections - Full Chapter
Notes:

When a bacterial pathogen is isolated from a clinical specimen and sensitivities are known, treatment should be adjusted to use the narrowest-spectrum antibiotic.The oral route of administration will be appropriate either on initiation or after 2 to 3 days of intravenous therapy. Certain infections e.g. severe sepsis, bacterial meningitis and neutropenic sepsis require intravenous antibiotics for the full period of treatment. All intravenous therapy should be reviewed at 48 hours (ideally daily). A switch from IV to oral therapy should be considered as soon as it is clinically appropriate with the exception of patients with osteomyelitis, necrotising fasciitis, septic arthritis and infections mentioned above. Initially when the infecting organism or the source of infection is unknown, 'broad-spectrum' antibiotics are appropriate. Once clarified (laboratory results), therapy should be altered to a 'narrow spectrum' agent to help minimise the risk of development of antimicrobial resistance. REFER TO TRUST/COMMUNITY ANTIMICROBIAL GUIDELINES , or the Antimicrobial Microguide app.

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing

Chapter Links...
 Details...
05.03.01  Expand sub section  HIV infection
 note  All prescribing for HIV patients should be in line with current BHIVA guidelines
05.03.01  Expand sub section  Nucleoside reverse transcriptase inhibitors
Abacavir (Ziagen)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
300mg Tablets
100mg/5mL Solution

Restricted - must be prescribed by HIV consultants only

 
   
Abacavir and Lamivudine
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Restricted - must be prescribed by HIV consultants only

Abacavir 600mg/Lamivudine 300mg Film Coated Tablets 
   
Abacavir and Lamivudine and Zidovudine (Trizivir)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Abacavir 300mg/Lamivuidine 150mg/Zidovudine 300mg

Restricted - must be prescribed by HIV consultants only 
   
Lamivudine
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Restricted - must be prescribed by HIV consultants only

100mg, 150mg & 300mg Tablets
100mg Film Coated Tablets
10mg/1mL Solution  
   
Tenofovir Disproxil (Viread)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING Blueteq or High cost drug form required see link from Formulary homepage - For Hepatitis B patients only.

245mg Tablets : Restricted - must be prescribed by Consultant Hepatologist for the treatment of Chronic hepatitis B in accordance with NICE TA173.

204mg tablets in combination with other antiretrovirals: To be prescribed by HIV consultants only.

 
Link  NICE CG165: Hepatitis B (chronic) - incorporates TA173
Link  NICE TA173: Hepatitis B (chronic) - tenofovir disoproxil
   
Tenofovir 245mg, Efavirenz 600mg and Emtricitabine 200mg (Atripla)
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Restricted Drug Restricted
Red
High Cost Medicine
Efavirenz 600mg/Emtricitabine 200mg/Tenofovir Disoproxil
245mg

Prescribe as Truvada PLUS generic efavirenz where possible.

Restricted - must be prescribed by HIV consultants only 
   
Tenofovir and Emtricitabine (Truvada)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Restricted - must be prescribed by HIV consultants only

Emtricitabine 200mg/Tenofovir 245mg Tablets  
Link  Department Of Health (April 2015) - EAGA guidance on HIV post-exposure prophylaxis
   
Tenofovir, cobicistat, elvitegravir & emtricitabine (Stribild)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Restricted - prescribing by HIV Consultants only in accordance with BHIVA guidelines.

Contains Tenofovir 245mg/Cobicistat 150mg/Elvitegravir 150mg/Emtricitabine 200mg Tablets 
   
Zidovudine and lamivudine
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Restricted - prescribing by HIV Consultants only.

Zidovudine 300mg / lamivudine 150mg 
   
Emtricitabine 200mg, Rilpivirine 25mg and Tenofovir 245mg (Eviplera)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Emtricitabine 200mg/Rilpivirine 25mg/Tenofovir Disproxil 245mg

Restricted - must be prescribed by HIV Consultants only  
   
Zidovudine
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Restricted - must be prescribed by HIV Consultants only

100mg & 250mg Capsules
50mg/5mL Syrup
200mg/20mL Injection  
   
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
05.03.01  Expand sub section  Pharmacokinetic enhancers of antiretrovirals
 ....
 Non Formulary Items
Didanosine  (Videx)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
No longer used
 
Emtricitabine  (Emtriva)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
No longer used as individual agent.
 
Stavudine  (Zerit)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
No longer used
 
  
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
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

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.  

Green

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

Amber SCG

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.   

Black

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.   

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