5.1 Antibacterial drugs

Related Topics :

Antimicrobial Usage

Antimicrobial Guidelines

Antimicrobial Selection

5.1.1 Penicillins - Used primarily for Gram +ve infections

Amoxicillin capsules 250mg, 500mg

F

 

Amoxicillin susp. 125mg/5ml, 250mg/5ml

F

 

Amoxicillin sachets 3g

F

 

Amoxicillin inj 250mg, 500mg, 1g

F

 

Benzylpenicillin inj 600mg (Penicillin G) 600mg = 1 megaunit (1 mu)

F

 

Co-amoxiclav injection 600mg, 1.2g

F

 

Co-amoxiclav tablets 375mg, 625mg

F

 

Co-amoxiclav dispersible tablets 375mg

F

 

Co-amoxiclav suspension 125/31, 250/62

F

 

Co-fluampicil syrup

R

(Ampicillin + Flucloxacillin)
Paediatrics

Flucloxacillin injection 250mg, 500mg, 1g

F

 

Flucloxacillin capsules 250mg, 500mg

F

 

Flucloxacillin susp 125mg/5ml, 250mg/5ml

F

 

Penicillin V tablets 250mg (Phenoxymethylpenicillin)

F

 

Penicillin V susp 125mg/5ml, 250mg/5ml

F

 

Tazocin Injection 4.5g

R

Piperacillin/tazobactam

Restricted to indications as recommended in the guidelines and for consultant microbiologist / respiratory physician

 

5.1.2 Cephalosporins and other beta-lactam antibiotics - The 3rd generation cephalosporins have greater activity against certain G-ve organisms than 2nd generation, however they are less active against G+ve organisms. About 10% of penicillin-sensitive patients will also be allergic to cephalosporins. Penicillin-sensitive patients may also be hypersensitive to carbapenems (imipenem and meropenem).

Cefuroxime injection 250mg, 750mg, 1.5g

F

 

Cephalexin tablets 250mg, 500mg

F

Only to be used for UTIs

Cephalexin susp 125mg/5ml, 250mg/5ml, 500mg/5ml

F

Ceftriaxone injection 250mg, 1g, 2g

F

 For treatment of suspected meningitis

Cefotaxime injection 500mg, 1g, 2g

F

 

Ceftazidime inj 250mg, 500mg, 1g, 2g

R

Serious pseudomonal infections only

Meropenem injection 1g

R

Cystic fibrosis/ Microbiology recommended

Primaxin inj 250mg, 500mg (imipenem with cilastatin)

F

Imipenem + cilastatin

NOTE - Please ensure cephalosporins are clearly written on the prescription chart and take care that the correct drug is administered as the names and packaging are often similar.

 

5.1.3 Tetracyclines

 

Demeclocycline capsules 150mg

F

For SIADH

Doxycycline capsules 100mg

F

 

Tetracycline tablets 250mg

F

 

 

5.1.4 Aminoglycosides - These may be given once daily. See extended interval gentamicin dosing.

Gentamicin injection 20mg/2ml, 80mg/2ml

F

 

Tobramycin injection 80mg/2ml

R

Cystic Fibrosis / Microbiology recommended

 

5.1.5 Macrolides

 

Azithromycin capsules 250mg

R

GU Medicine / Cystic Fibrosis / Obs & Gyne or Consultant Microbiologist only

Clarithromycin injection 500mg

F

Switch to oral Erymax

Clarithromycin tablets 250mg

R

H.pylori eradication only

Erythromycin capsules 250mg (Erymax)

F

 

Erythromycin susp 125mg/5ml, 250mg/5ml, 500mg/5ml

F

 

 

5.1.6/7 Other Antibiotics

 

Chloramphenicol capsules 250mg

R

 

Chloramphenicol injection 1g

R

 

Chloramphenicol susp 125mg/5ml

R

 

Clindamycin capsules 150mg

F

 

Clindamycin injection 300mg/2ml

F

 

Linezolid infusion 600mg/300ml

R

Consultant Microbiologist recommendation only. Check interactions.

Linezolid tablets 600mg

R

Consultant Microbiologist recommendation only. Check interactions.

Nitrofurantoin tablets 50mg

F

UTI, based on sensitivities

Sodium fusidate tablets 250mg

R

 

Sodium fusidate susp 250mg/5ml (as fusidic acid)

R

 

Teicoplanin injection 200mg, 400mg

R

Consultant Microbiologist recommendation only

Vancomycin injection 500mg

F

May be used orally as a 2nd line agent to metronidazole for C.difficile. Monitor levels with IV use

 

5.1.8 Sulphonamides and trimethoprim

 

Co-trimoxazole preparations

R

Prophylaxis of Pneumocystis infections

Trimethoprim 200mg tablets

F

 

 

5.1.9 Antituberculous drugs - drugs for the treatment of TB should be initiated by consultant respiratory / infectious disease physicians.

Ethambutol tablets 100mg, 400mg

R

 

Isoniazid injection 50mg/2ml

R

 

Isoniazid tablets 50mg, 100mg

R

 

Pyrazinamide tablets 500mg

R

Unlicensed in UK

Rifampicin capsules 150mg, 300mg

R

Also on the recommendation of microbiology

Rifampicin injection

R

Also on the recommendation of microbiology

Rifater tablets

R

Rifampicin + isoniazid + pyrazinamide

Rifinah tablets

R

Rifampicin + isoniazid

 

5.1.11 Metronidazole

 

Metronidazole infusion 500mg

F

 

Metronidazole injection 100mg/20ml

R

SCBU

Metronidazole suspension 200mg/5ml

F

 

Metronidazole suppositories 500mg, 1g

F

 

Metronidazole tablets 200mg, 400mg

F

 

 

5.1.12 4-Quinolones - IV ciprofloxacin should only be used for patients who are nil by mouth due to the excellent bioavailability following the oral route. A 400mg IV dose achieves the same peak plasma level as an oral dose of 750mg.

Ciprofloxacin infusion 100mg, 200mg, 400mg

F

 NBM patients only

Ciprofloxacin tablets 250mg, 500mg

F

 

Levofloxacin infusion 500mg

R

Restricted to transplant patients under the care of Dr Leonard and microbiologist recommendation only

Levofloxacin tablets 500mg

R

Restricted to transplant patients under the care of Dr Leonard and microbiologist recommendation only

Moxifloxacin

R

Consultant Microbiologist recommendation only

Nalidixic acid suspension 300mg/5ml

F

UTI, based on sensitivities

Nalidixic tablets 500mg

F