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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 5 - Infections 
Notes:

For full details on UKHSA guidance for managing common infections with local amendments please see:

BLMK Primary Care Antimicrobial Guidelines hosted via: https://blmkantibioticspubliclive.azurewebsites.net/

Secondary care antimicrobial guidelines:

Bedfordshire Hospitals Foundation Trust: Antimicrobial guidelines are hosted on:  EOLAS Medical App. 
05.01.02 Cephalosporins, carbapenems and other beta-lactums
NICE NG15: Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use
05.01.02 Cephalosporins
Due to the high association with Clostridium difficile infection, cephalosporins must only be prescribed in accordance with the approved indications for use listed in the Antimicrobial guideline or by recommendation from the Microbiologist. 
NICE NG15: Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use

Cefalexin
(oral)

GREEN
Restricted Drug Restricted

250mg & 500mg Capsules
125mg/5mL & 250mg/5mL Suspension

Restricted to Paediatrics and Obs & Gynae in-patients.

BNF BNFc SPC

Cefepime 1g, 2g
(Injection)

RED
Restricted Drug Restricted
Restricted to recommendation by Consultant Microbiologist only.

Last line choice where sensitivity is known in severe uncomplicated pyelonephritis or certain respiratory tract infections.

BNF BNFc SPC

Cefiderocol Sulfate Tosylate 1g (Fetcroja® )
(powder for infusion)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Microbiology recommendation only.
For multi-drug resistant infections where no alternative antimicrobial agent is likely to be effective.

 

DTC approved: November 2022

BNF BNFc SPC BlueTeq

Cefotaxime
(injection)

RED
Restricted Drug Restricted

500mg, 1g & 2g Injection

Must only be prescribed in accordance with the Luton & Dunstable Trust's Antimicrobial Guidelines or by recommendation from a Consultant Microbiologist.

If ceftriaxone is unavailable, prescribe cefotaxime 2g QDS for adult patients with suspected meningitis.

BNF BNFc SPC

Ceftazidime
(injection)

RED
Restricted Drug Restricted

500mg, 1g & 2g Injection

Must only be prescribed in accordance with the Luton & Dunstable Trust's Antimicrobial Guidelines or by recommendation from a Consultant Microbiologist.

BNF BNFc SPC

Ceftazidime 2g/ avibactam 0.5g (Zavicefta® )
(injection)

RED
Restricted Drug Restricted

Microbiology recommendation only.
For multi-drug resistant infections where no alternative antimicrobial agent is likely to be effective.

BNF BNFc SPC

Ceftriaxone 250mg, 1g, 2g
(Injection)

 
Restricted Drug Restricted

Green When prescribed in accordance with BLMK Antimicrobial guidelines for suspected meningitis if transfer to hospital is delayed.

Amber SPA When prescribed in accordance with BLMK Antimicrobial guidelines for gonorrhoea and pelvic inflammatory disease.

Red Must only be prescribed in accordance with the Luton & Dunstable Trust's Antimicrobial Guidelines or by recommendation from a Consultant Microbiologist.

Entry reviewed: July 2024

BNF BNFc SPC

Cefuroxime
(injection)

RED
Restricted Drug Restricted

250mg, 750mg & 1.5g Injection

Must only be prescribed in accordance with the Luton & Dunstable Trust's Antimicrobial Guidelines or by recommendation from a Consultant Microbiologist.

BNF BNFc SPC
05.01.02 Other beta-lactam antibiotics
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.