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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

Chapter Links...
 Details...
05.04.01  Expand sub section  Antimalarials
05.04.01  Expand sub section  Treatment of malaria
05.04.01  Expand sub section  Falciparum malaria (treatment)
05.04.01  Expand sub section  Benign malarias (treatment)
05.04.01  Expand sub section  Prophylaxis against malaria to top
05.04.01  Expand sub section  Specific recommendations
05.04.01  Expand sub section  Artemether with lumefabtrine
Artemether with lumefantrine 20mg/ 120mg (Riamet)
(Tablets )
View adult BNF View SPC online View childrens BNF
First Choice
Red
First choice in uncomplicated FALCIPARUM malaria.

N.B. Complex dosing regime. Use BNF / BNFC or SPC for dose.
Prescribe on ePMA using stat timed doses.

To increase absorption, tablets should be taken with food or a milky drink. If patients are unable to tolerate food, tablets should be administered, but the systemic exposure may be reduced. Patients who vomit within 1 hour of taking the medication should repeat the dose.
For administration to small children and infants, tablets may be crushed. 
05.04.01  Expand sub section  Chloroquine
05.04.01  Expand sub section  Mefloquine
05.04.01  Expand sub section  Primaquine to top
05.04.01  Expand sub section  Proguanil
05.04.01  Expand sub section  Pyrimethamine
05.04.01  Expand sub section  Quinine
05.04.01  Expand sub section  Tetracyclines
 ....
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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