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Bedfordshire and Luton Joint Formulary
Bedford Hospital NHS Trust
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

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 Details...
05.03.02  Expand sub section  Herpesvirus infections
05.03.02.01  Expand sub section  Herpes simplex and varicella-zoster infection
Aciclovir
(Oral)
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First Choice
Green
200mg Dispersible Tablets
400mg & 800mg Tablets
200mg/5mL & 400mg/5mL Sugar Free Suspension
 
Valaciclovir
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Restricted Drug Restricted
Green
500mg tablets.

Valaciclovir is a prodrug of aciclovir. Not for in-patient use.

Restricted: Luton Sexual Health clinic or for patients who cannot adhere to the 5 x daily aciclovir regime. 
   
Aciclovir 250mg, 500mg
(Intravenous infusion)
View adult BNF View SPC online View childrens BNF
Formulary
Red
N.B. Obese patients should have the dose calculated on ideal bodyweight to prevent excessive dosing. 
   
05.03.02.02  Expand sub section  Cytomegalovirus infrection
Foscarnet Sodium (Foscavir)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Restricted - must be initiated by GUM or Microbiology consultants

 
   
Ganciclovir 500mg (Cymevene)
(Injection)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Restricted - must be initiated by GUM or Microbiology consultants
Not NHS Commissioned by NHS England for cytomegalovirus infection according to Trust guidelines
 
   
Valganciclovir (Valcyte)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Not NHS. Commissioned by NHS England for cytomegalovirus infection according to licensed indications (see SPC). 
   
 ....
 Non Formulary Items
Aciclovir lauriad  (Sitavig)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cidofovir infusion  (Vistide)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Famciclovir  (Famvir)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
 
Inosine Pranobex  (Imunovir)

View adult BNF View SPC online View childrens BNF
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
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Link to adult BNF
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Link to children's BNF
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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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