Prescribing of systemic antimicrobials is 'protected'. All prescribing MUST be in accordance with the Trust Antimicrobial Policy and in conjunction with local antimicrobial guideline:
Cryptococcosis – treatment (Restricted to Microbiology approval)
Serious fungal infections (Restricted to Microbiology approval for intraventricular disease)
WH:
Non-formulary
Amphotericin liposomal infusion
(AmBisome®)
Restricted
Provider notes
NMUH:
As per Trust Guidelines
RFL:
Restricted to OLT prophylaxis (2nd transplant/hepatic artery thrombosis)
Microbiology/ID approval required for all other indications
RNOH:
Microbiology approval only
UCLH:
WH:
Microbiology approval only
Fluconazole
Restricted
Provider notes
NMUH:
Infusion restricted to Microbiology Consultants use only
RFL:
No restriction stated
RNOH:
No restriction stated
UCLH:
WH:
Restricted antifungal. Microbiology approval only
Flucytosine infusion
Restricted
Provider notes
NMUH:
Restricted to Microbiology Consultants use only
RFL:
Microbiology / ID approval required
RNOH:
Non-formulary
UCLH:
WH:
Microbiology approval only
Griseofulvin
Formulary
Provider notes
NMUH:
No restriction stated
RFL:
No restriction stated
RNOH:
Non-formulary
UCLH:
WH:
No restriction stated
Isavuconazole capsules/infusion
Formulary
Approved for treatment of proven or probable invasive aspergilosis or mucomycosis where other antifungals are not appropriate (JFC August 2020)
Provider notes
NMUH:
As per JFC decision above
On microbiology recommendation ONLY
RFL:
Non-formulary
RNOH:
Non-formulary
UCLH:
WH:
Non-formulary
Itraconazole
Restricted
Provider notes
NMUH:
No restriction stated
RFL:
Oral: Restricted to Dermatology; HIV; Haematology. ID/Microbiology approval for all other indications.
Intravenous: Microbiology/ID approval
RNOH:
Microbiology approval only
UCLH:
WH:
For restricted indications as per Trust guidelines or Microbiology advice
Posaconazole
Restricted
Provider notes
NMUH:
Liquid: Restricted to Haematology and Oncology for prophylaxis; Microbiology approval required for treatment doses and all other indications
Tablets: Microbiology/ID approval required
RFL:
Liquid: Restricted to Haematology and Oncology for prophylaxis; Microbiology approval required for treatment doses and all other indications
Tablets: Microbiology/ID approval required
RNOH:
Non-formulary
UCLH:
WH:
Non-formulary
Terbinafine tabs
Restricted
Provider notes
NMUH:
Restricted to Dermatology use only
RFL:
No restriction stated
RNOH:
No restriction stated
UCLH:
WH:
No restriction stated
Voriconazole
Restricted
Provider notes
NMUH:
Microbiology approval required
See MHRA Drug Safety Updates
RFL:
Microbiology approval required
RNOH:
Microbiology approval required
UCLH:
WH:
Check with Microbiology
Flucytosine tablets
Unlicensed
Provider notes
NMUH:
Non-formulary
RFL:
Microbiology / ID approval required
RNOH:
Non-formulary
UCLH:
WH:
500mg tablets
05.02
Treatment of fungal infections
05.02
Drugs used in fungal infections
05.02.01
Triazole antifungals
05.02.02
Imidazole antifungals
05.02.03
Polyene antifungals
05.02.04
Echinocandin antifungals
Anidulafungin
Restricted
Approved for invasive candidiasis, subject to local Antimicrobial Committee approval (JFC February 2019).
Provider notes
NMUH:
To be used as per Trust antifungal guidelines
RFL:
Non-formulary
RNOH:
Non-formulary
UCLH:
WH:
Microbiology approval only
Caspofungin
Restricted
Provider notes
NMUH:
Microbiology consultant approval only
RFL:
See Microguide for agreed indications
Restricted to Haematology / Oncology as per policy
Microbiology approval required for all other indications.
RNOH:
Microbiology approval only
Store in a fridge
UCLH:
WH:
Reserved for prescribing by paediatric consultants only
05.02.05
Other antifungals
....
Non Formulary Items
Amphotericin lipid complex infusion
(Abelcet®)
Non Formulary
Ketoconazole tablets (Antifungal)
Non Formulary
NOTE: There is more than one monograph for this medicine, click hereto search for formulary status and its use for other indications.
License withdrawn for this indication
Micafungin
Non Formulary
Key
Notes
Section Title (top level)
Section Title (sub level)
First Choice item
Non Formulary section
Restricted Drug
Unlicensed
Display tracking information
Link to adult BNF
Link to children's BNF
Link to SPCs
Homecare
Traffic Light Status Information
Status
Description
Medicines that should be initiated by a specialist. Prescribing can be transferred to primary care once the patient has been stabilised.
Shared care: For drugs with regular, ongoing need for monitoring and/or assessment of efficacy or toxicity. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the North Central London JFC.
Fact sheet: For drugs with some concerns surrounding safety or efficacy but do not require regular monitoring and/or monitoring of effectiveness/toxicity.
Medicines which should normally be prescribed by specialists only (hospital only).
For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
Medicines not recommended for routine use in primary or secondary care.
Medicines, which the North Central London JFC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
Restricted
Unlicensed
