PROTECTED ANTIMICROBIALS

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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 

Ceftazidime/avibactam

Ceftazidime

CF, endophthalmitis, suspected CAPD peritonitis 

Ceftolozane/tazobactam

Ceftriaxone

Meningitis, supraglottitis, orbital cellulitis, paediatric sepsis 

Chloramphenicol (systemic)

Cefuroxime

Paediatrics (LRTI, AOM) 

Colistimethate sodium

Clindamycin

Pyrexia in labour, necrotising fasciitis, paediatrics 

Dalbavancin

Gentamicin

Up to 3 days for all indications 

Daptomycin

Linezolid *

ITU for S aureus pneumonia 

Ertapenem

Meropenem

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

Fidaxomicin

Piperacillin/

tazobactam

NS, diabetic food infection

 

Fosfomycin (injection)

Posaconazole

Haematology prophylaxis 

Moxifloxacin

Teicoplanin

NS

Posaconazole (other than haematology prophylaxis)

Voriconazole

NS step down

Temocillin

Tigecycline


 * 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. Pharmacy stock for in-patient areas in Argyll and Bute is provided by NHS Greater Glasgow and Clyde (NHS GGC) – please note 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.     

For glossary of terms see Glossary   

Process Flowchart

Editorial Information

Last reviewed: 23 April 2020

Next review: 23 April 2023

Author(s): Antimicrobial Management Team

Version: 2

Approved By: TAM Subgroup of ADTC

Reviewer Name(s): Area Antimicrobial Pharmacist

Document Id: AMT147