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 Formulary Chapter 5: Infections - Full Chapter
Notes:

 

1. Wherever possible antibiotics should be prescribed orally

2. Antibiotics should be:

  • Administered only for as long as necessary to treat the infection
  • Changed from IV to oral as soon as possible

3. Sugar free liquids are preferred where available, and SF identifies where a sugar free product is available.

4. For young children requiring doses of less than 5ml an oral syringe will be dispensed.

 

Suspected Meningitis

Pre-admission management for suspected meningitis can be found here: http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1194947389261

Notes: 

1. All GPs should carry benzylpenicillin for injection and administer it whilst arranging the transfer of the case to hospital, unless there is a history of immediate allergic reactions after previous penicillin administration.

2. GPs do not need to carry an alternative antibiotic. However, if other antibiotics are available, a 3rd generation cephalosporin may be used. If there is a history of immediate allergic reactions to penicillin or cephalosporins, chloramphenicol may be used.

3. Immediate dose of IV/IM benzylpenicillin for suspected meningococcal infection

  • Adults and children aged 10 years or over - 1.2g
  • Children aged 1 to 9 years - 600mg 
  • Children aged under 1 year - 300mg 
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05.03.03.01  Expand sub section  Chronic hepatitis B
Adefovir Dipivoxil (Hepsera)
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Tablets 2mg

 
Link  NICE CG165: Hepatitis B (chronic) - incorporates TA96
Link  NICE TA96: Hep B - adefovir dipivoxil and pegylated interferon alpha-2a
   
Entecavir (Baraclude)
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  • Tablets 500micrograms, 1mg
  • Oral solution 50micrograms/mL

Note:

  • Entecavir should be used second-line for Chronic Hepatitis B in cases of treatment failure or pre-selected resistance to Tenofavir.
 
Link  NICE CG165: Hepatitis B (incorporates TA153)
Link  NICE TA153: Hepatitis B (chronic) - entecavir
   
 ....
 Non Formulary Items
Tenofovir alafenamide fumarate  (Vemlidy)

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Routine prescribing within licensed indication  

Amber 1

Specialist recommendation followed by GP initiation and continuation  

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Specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation   

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Specialist initiation and stabilisation followed by GP continuation  

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Specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline  

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Hospital or specialist prescribing only  

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These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.  

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