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 Formulary Chapter 5: Infections - Full Chapter
Notes:

This formulary indicates prescribing status only, for guidance on managing infections please refer to your local antibiotic guidelines

Summary of antimicrobial prescribing guidance - managing common infections

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05.02  Expand sub section  Antifungal drugs
Amphotericin
(Infusion)
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Formulary
Specialist only
 
 
Amphotericin
(Lipid Complex Infusion)
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Formulary
Specialist only
 
 
Amphotericin (AmBisome ®)
(IV Infusion)
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Formulary
Specialist only
 
 
Amphotericin (Fungizone ®)
(IV Infusion)
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Formulary
Specialist only
 
 
Flucytosine
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Formulary
Specialist only
 
 
Nystatin
(Oral suspension)
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Formulary
All settings

Not sugar Free

 
Link  Summary of antimicrobial prescribing guidance – managing common infections
 
Terbinafine
(Tablets)
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Formulary
All settings
 
Link  Summary of antimicrobial prescribing guidance – managing common infections
 
05.02.01  Expand sub section  Triazole antifungals
Fluconazole
(infusion)
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Formulary
Specialist only
 
 
Fluconazole
(Oral presentations)
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Formulary
All settings

Capsules 

Suspension - Only for patients with swallowing difficulties 

 
Link  Summary of antimicrobial prescribing guidance – managing common infections
Link  UKMI Q&A: Can oral fluconazole be used with breastfeeding?
 
Isavuconazole
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Formulary
Specialist only
 
 
Itraconazole
(Injection)
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Formulary
Specialist only
 
 
Itraconazole (oral presentations)
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Formulary
All settings

Capsules more cost effective

SF Liquid £££££

 
Link  Summary of antimicrobial prescribing guidance – managing common infections
 
Posaconazole
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Formulary
Specialist only
 
 
Voriconazole
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Formulary
Specialist only
 
 
05.02.02  Expand sub section  Imidazole antifungals
Ketoconazole
(Oral)
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Formulary
Specialist only

Specialist use only

 
Link  MHRA alert: Risk of hepatotoxicity with oral ketoconazole
 
05.02.03  Expand sub section  Polyene antifungals
05.02.04  Expand sub section  Echinocandin antifungals to top
Anidulafungin
(IV)
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Formulary
Specialist only
 
 
Caspofungin
(injection)
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Formulary
Specialist only
 
 
Micafungin
(infusion)
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Formulary
Specialist only
 
 
05.02.05  Expand sub section  Other antifungals
Flucytosine (Ancotil®)
(infusion)
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Formulary
Specialist only
 
 
Griseofulvin
(Oral presentations)
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Formulary
All settings
 
 
Sotrovimab
(IV)
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Formulary
Specialist only
 
 
 ....
 Non Formulary Items
Fluconazole

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Non Formulary

Capsules 

Suspension - Only for patients with swallowing difficulties 

Griseofulvin  (Fulsolvin®)

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Non Formulary
  
Key
Restricted Drug Restricted Drug
Unlicensed Drug Unlicensed
click to search medicines.org.uk
Link to adult BNF
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Link to children's BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
ICB
ICB
Green Low Carbon

Low carbon footprint

Amber Medium Carbon

Medium carbon footprint

Red High carbon footprint

High carbon footprint

Status Description

All settings

All Settings
Suitable for initiation, ongoing prescribing, and discontinuation in both primary and secondary care settings. They are generally familiar, frequently used therapies that can be started within their licensed indications without specialist oversight.  

Specialist only

Specialist only
Designated for initiation, ongoing prescribing, monitoring, exclusively by a specialists either in a hospital or as part of a specialist service (to note this could be in a non-hospital setting). Primary care should neither start nor continue these treatments except as part of a specialist service. A specialist could be either a medical or non-medical prescriber.  

Specialist advice

Specialist advice
Prescribers in primary care should seek advice and a recommendation from a specialists prior to initiating a medicine. Once agreed with a specialist, medicines can be initiated, prescribed and monitored in primary care without a formal shared-care agreement.   

Specialist initiation

Specialist initiation
Medicines in this category require a specialist to start therapy, titrate dosage, and assess initial efficacy or tolerability. Once stabilised, prescribing responsibility may transfer to primary care without the need for a formal shared-care agreement.  

Shared care agreement

Shared care agreement
Prescribing responsibility can be shared across health settings and between specialists and GPs only when formal shared care arrangement has been made. For example, there may be extensive and complex monitoring requirements or significant safety concerns (note would need a national policy on this to define the criteria for requiring a formal SCA), this will be produced once nationally.  

Do not prescribe

Do not prescribe
Not approved for routine prescribing in primary or secondary care. For example, because they are agents classified in the BNF as “not NHS” or “Drugs of Low Clinical Value”, or they are products on NICE’s “do not do” list or NHS England’s “should not routinely prescribe” list.  

Self Care

Self Care
Not for routine prescribed in primary or secondary care unless as part of care for a long term condition. Instead, patients should be encouraged to self care with support from community pharmacy.   

Green

Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications  

Amber Initiation

Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry.  

Amber SC

Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry.  

Amber Recommended

Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist.  

Red

Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only  

Grey

Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.  

Black

Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

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