PROTECTED ANTIMICROBIALS

exp date isn't null, but text field is

The antimicrobials in tables 1 and 2 are restricted. Their use must be authorised by a consultant microbiologist or infectious diseases physician.

Initial prescription allowed for APPROVED INDICATIONS ONLY

 

Authorisation required BEFORE prescribing

Table 1 Key: NS = Neutropenic sepsis CF = Cystic fibrosis PA = Penicillin allergy

Table 2

DRUG

Approved Indication

 

DRUG

Ambisome®

NS, endophthalmitis

 

Amikacin

Caspofungin

NS, ITU

 

Anidulafungin

Cefotaxime

Meningitis, paediatric sepsis

 

Chloramphenicol (systemic)

Ceftazidime

CF, endophthalmitis, suspected CAPD peritonitis

 

Colistimethate sodium

Ceftriaxone

Meningitis, supraglottitis, orbital cellulitis, paediatric sepsis

 

Dalbavancin

Cefuroxime

Paediatrics (LRTI, AOM)

 

Daptomycin

Clindamycin

Pyrexia in labour, necrotising fasciitis, paediatrics

 

Ertapenem

Gentamicin

Up to 3 days for all indications

 

Fidaxomicin

Linezolid *

ITU for S aureus pneumonia

 

Fosfomycin (injection)

Meropenem

ITU, CF, NS, severe sepsis (PA), severe diabetic foot (PA), necrotising fasciitis

 

Moxifloxacin

Piperacillin/

tazobactam

NS, diabetic food infection

 

Temocillin

 

Posaconazole

Haematology prophylaxis

 

Tigecycline

Teicoplanin

NS

 

Posaconazole (other than haematology prophylaxis)

 

Voriconazole

NS step down

 

 * Current arrangements for supply of linezolid by prescription will remain. 

To ensure timely appropriate treatment of certain infections, there are specific situations where this authorisation is not immediately required, as detailed above in table 1, however this authorisation must be obtained within 24 hours.

In order to obtain authorisation, contact the duty consultant microbiologist in Raigmore via the laboratory on Ext 4206 (out of hours, via switchboard) or the infectious diseases physician via switchboard. Microbiology advice to prescribers in Argyll and Bute is provided by NHS Greater Glasgow and Clyde (NHS GGC). An equivalent authorisation process is not used by NHS GGC.

A code will be provided and must be written:

  1. in the notes as part of the Micro/ID discussion,
  2. on the drug chart beside the antimicrobial in question
  3. on the ward order form before sending to Pharmacy.

This code is checked by Pharmacy staff and if appropriate, the antimicrobial is supplied to the ward.

In the absence of a valid authorisation code, no antimicrobial will be supplied, and the ward pharmacist will contact the prescriber who is welcome to discuss with a consultant microbiologist.        

Process Flowchart