TAM (Treatments and Medicines) NHS Highland
PROTECTED ANTIMICROBIALS (Antimicrobial)
Warning
The antimicrobials in tables 1 and 2 are restricted. Their use MUST be authorised by a consultant microbiologist or infectious diseases physician.
To ensure timely, appropriate treatment of certain infections, there are specific situations where this authorisation is not immediately required, as detailed in table 1. However, this authorisation must be obtained within 24 hours.
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Table 1: Initial prescription allowed for APPROVED INDICATIONS ONLY |
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DRUG |
Approved Indication |
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Ambisome® |
Neutropenic sepsis, endophthalmitis |
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Caspofungin |
Neutropenic sepsis, ITU |
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Cefotaxime |
Meningitis, paediatric sepsis |
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Ceftazidime |
Cystic fibrosis, endophthalmitis, suspected CAPD peritonitis |
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Ceftriaxone |
Meningitis, supraglottitis, orbital cellulitis, paediatric sepsis |
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Cefuroxime |
Paediatrics (LRTI, AOM) |
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Clindamycin |
Pyrexia in labour, necrotising fasciitis, paediatrics |
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Gentamicin |
Up to 3 days for all indications |
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Linezolid |
ITU for S aureus pneumonia\current arrangements for supply of linezolid by prescription will remain |
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Meropenem |
ITU, cystic fibrosis, neutropenic sepsis, severe sepsis (penicillin allergy), severe diabetic foot (penicillin allergy), necrotising fasciitis |
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Piperacillin/tazobactam |
Neutropenic sepsis, diabetic food infection |
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Posaconazole |
Haematology prophylaxis |
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Teicoplanin |
Neutropenic sepsis |
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Voriconazole |
Neutropenic sepsis step down |
| Table 2: Authorisation required BEFORE prescribing |
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Amikacin |
Highland HSCP (North Highland): In primary and secondary care, 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.
- Secondary care: a code will be provided and must be written:
- in the notes as part of the Micro/ID discussion,
- on the drug chart beside the antimicrobial in question and
- 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.
- Primary care: these antimicrobials should only be used following discussion with, or on the advice of, an infection specialist. This should be recorded in the patient notes.
Argyll & Bute HSCP: Pharmacy stock for in-patient areas is provided by NHS Greater Glasgow and Clyde – please note an equivalent authorisation process is not used by NHS GGC.
For glossary of terms see Glossary.