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Related Topics : |
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Antimicrobial Guidelines |
Antimicrobial Selection |
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5.1.1 Penicillins - Used primarily for Gram +ve infections |
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Amoxicillin capsules 250mg, 500mg |
F |
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Amoxicillin susp. 125mg/5ml, 250mg/5ml |
F |
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Amoxicillin sachets 3g |
F |
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Amoxicillin inj 250mg, 500mg, 1g |
F |
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Benzylpenicillin inj 600mg (Penicillin G) 600mg = 1 megaunit (1 mu) |
F |
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Co-amoxiclav injection 600mg, 1.2g |
F |
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Co-amoxiclav tablets 375mg, 625mg |
F |
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Co-amoxiclav dispersible tablets 375mg |
F |
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Co-amoxiclav suspension 125/31, 250/62 |
F |
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Co-fluampicil syrup |
R |
(Ampicillin + Flucloxacillin) |
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Flucloxacillin injection 250mg, 500mg, 1g |
F |
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Flucloxacillin capsules 250mg, 500mg |
F |
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Flucloxacillin susp 125mg/5ml, 250mg/5ml |
F |
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Penicillin V tablets 250mg (Phenoxymethylpenicillin) |
F |
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Penicillin V susp 125mg/5ml, 250mg/5ml |
F |
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Tazocin Injection 4.5g |
R |
Piperacillin/tazobactam Restricted to indications as recommended in the guidelines and for consultant microbiologist / respiratory physician |
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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). |
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Cefuroxime injection 250mg, 750mg, 1.5g |
F |
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Cephalexin tablets 250mg, 500mg |
F |
Only to be used for UTIs |
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Cephalexin susp 125mg/5ml, 250mg/5ml, 500mg/5ml |
F |
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Ceftriaxone injection 250mg, 1g, 2g |
F |
For treatment of suspected meningitis |
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Cefotaxime injection 500mg, 1g, 2g |
F |
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Ceftazidime inj 250mg, 500mg, 1g, 2g |
R |
Serious pseudomonal infections only |
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Meropenem injection 1g |
R |
Cystic fibrosis/ Microbiology recommended |
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Primaxin inj 250mg, 500mg (imipenem with cilastatin) |
F |
Imipenem + cilastatin |
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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. |
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5.1.3 Tetracyclines |
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Demeclocycline capsules 150mg |
F |
For SIADH |
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Doxycycline capsules 100mg |
F |
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Tetracycline tablets 250mg |
F |
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5.1.4 Aminoglycosides - These may be given once daily. See extended interval gentamicin dosing. |
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Gentamicin injection 20mg/2ml, 80mg/2ml |
F |
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Tobramycin injection 80mg/2ml |
R |
Cystic Fibrosis / Microbiology recommended |
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5.1.5 Macrolides |
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Azithromycin capsules 250mg |
R |
GU Medicine / Cystic Fibrosis / Obs & Gyne or Consultant Microbiologist only |
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Clarithromycin injection 500mg |
F |
Switch to oral Erymax |
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Clarithromycin tablets 250mg |
R |
H.pylori eradication only |
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Erythromycin capsules 250mg (Erymax) |
F |
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Erythromycin susp 125mg/5ml, 250mg/5ml, 500mg/5ml |
F |
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5.1.6/7 Other Antibiotics |
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Chloramphenicol capsules 250mg |
R |
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Chloramphenicol injection 1g |
R |
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Chloramphenicol susp 125mg/5ml |
R |
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Clindamycin capsules 150mg |
F |
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Clindamycin injection 300mg/2ml |
F |
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Linezolid infusion 600mg/300ml |
R |
Consultant Microbiologist recommendation only. Check interactions. |
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Linezolid tablets 600mg |
R |
Consultant Microbiologist recommendation only. Check interactions. |
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Nitrofurantoin tablets 50mg |
F |
UTI, based on sensitivities |
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Sodium fusidate tablets 250mg |
R |
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Sodium fusidate susp 250mg/5ml (as fusidic acid) |
R |
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Teicoplanin injection 200mg, 400mg |
R |
Consultant Microbiologist recommendation only |
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Vancomycin injection 500mg |
F |
May be used orally as a 2nd line agent to metronidazole for C.difficile. Monitor levels with IV use |
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5.1.8 Sulphonamides and trimethoprim |
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Co-trimoxazole preparations |
R |
Prophylaxis of Pneumocystis infections |
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Trimethoprim 200mg tablets |
F |
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5.1.9 Antituberculous drugs - drugs for the treatment of TB should be initiated by consultant respiratory / infectious disease physicians. |
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Ethambutol tablets 100mg, 400mg |
R |
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Isoniazid injection 50mg/2ml |
R |
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Isoniazid tablets 50mg, 100mg |
R |
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Pyrazinamide tablets 500mg |
R |
Unlicensed in UK |
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Rifampicin capsules 150mg, 300mg |
R |
Also on the recommendation of microbiology |
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Rifampicin injection |
R |
Also on the recommendation of microbiology |
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Rifater tablets |
R |
Rifampicin + isoniazid + pyrazinamide |
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Rifinah tablets |
R |
Rifampicin + isoniazid |
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5.1.11 Metronidazole |
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Metronidazole infusion 500mg |
F |
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Metronidazole injection 100mg/20ml |
R |
SCBU |
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Metronidazole suspension 200mg/5ml |
F |
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Metronidazole suppositories 500mg, 1g |
F |
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Metronidazole tablets 200mg, 400mg |
F |
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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. |
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Ciprofloxacin infusion 100mg, 200mg, 400mg |
F |
NBM patients only |
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Ciprofloxacin tablets 250mg, 500mg |
F |
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Levofloxacin infusion 500mg |
R |
Restricted to transplant patients under the care of Dr Leonard and microbiologist recommendation only |
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Levofloxacin tablets 500mg |
R |
Restricted to transplant patients under the care of Dr Leonard and microbiologist recommendation only |
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Moxifloxacin |
R |
Consultant Microbiologist recommendation only |
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Nalidixic acid suspension 300mg/5ml |
F |
UTI, based on sensitivities |
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Nalidixic tablets 500mg |
F |
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