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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. 
05.01.04 Aminoglycosides
NICE NG15: Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use

Gentamicin 20mg/2mL, 80mg/2mL
(Injection)

RED
Formulary

Refer to CG619T Antimicrobial Guidelines for Treatment of Common Infections for further information.

Guidelines are also available in the following app: Eolas Medical

You will need to create an account for access.

Updated: May 2025

BNF BNFc SPC
MHRA Drug Safety Update (January 2021): Aminoglycosides (gentamicin, amikacin, tobramycin, and neomycin): increased risk of deafness in patients with mitochondrial mutations

Amikacin
(Injection)

RED
Restricted Drug Restricted

100mg/2mL & 500mg/2mL vial

Refer to CG619T Antimicrobial Guidelines for Treatment of Common Infections for further information.

Guidelines are also available in the following app: Eolas Medical

You will need to create an account for access.

Updated: May 2025

BNF BNFc SPC
MHRA Drug Safety Update (January 2021): Aminoglycosides (gentamicin, amikacin, tobramycin, and neomycin): increased risk of deafness in patients with mitochondrial mutations

Neomycin sulfate 500mg
(Tablets)

RED
Restricted Drug Restricted

Approved as part of bowel prep prior to colorectal surgery at a dose of 1g TDS for one day.

Not to be prescribed for any other indications.

BNF BNFc SPC
MHRA Drug Safety Update (January 2021): Aminoglycosides (gentamicin, amikacin, tobramycin, and neomycin): increased risk of deafness in patients with mitochondrial mutations

Tobramycin 300mg/4mL
(Nebuliser Solution)

RED
Restricted Drug Restricted

Restricted - initiation by consultant Paediatricians specialising in Cystic Fibrosis for the management of chronic pulmonary infection due to Pseudomonas aeruginosa in patients with cystic fibrosis aged 6 years and older if nebulised colistin is not tolerated or if clinical progress is unsatisfactory.

For use in adult patients with non-cystic fibrosis bronchiectasis – Specialist only prescribing. Blueteq or High cost drug form required – see link from Formulary homepage (NB - listed under 'nebulised antibiotics' on Blueteq).

High Cost Drug funded by NHS England for Cystic Fibrosis and CCGs for non-cystic fibrosis bronchiectasis only.

BNF BNFc SPC
JPC Bulletin: Use of Nebulised Tobramycin and Nebulised Colistimethate sodium as Antibiotic Prophylaxis to prevent exacerbations of Non- Cystic Fibrosis Bronchiectasis in Adult Patients

Tobramycin 80mg/2mL
( Injection )

RED
Restricted Drug Restricted
Must only be prescribed in accordance with the Luton & Dunstable Trust's Antimicrobial Guidelines or by recommendation from a Consultant Microbiologist.
BNF BNFc SPC
MHRA Drug Safety Update (January 2021): Aminoglycosides (gentamicin, amikacin, tobramycin, and neomycin): increased risk of deafness in patients with mitochondrial mutations

Tobramycin inhaler 28mg (TOBI Podhaler®)
(Dry powder for inhalation)

RED
Restricted Drug Restricted
Restricted - initiation by consultant Paediatricians specialising in Cystic Fibrosis for the management of chronic pulmonary infection due to Pseudomonas aeruginosa in patients with cystic fibrosis aged 6 years and older in accordance with NICE TA 276

To be used second line to tobramycin nebuliser solution (Bramitob®)

High cost drug funded by NHS England for this indication only.
BNF BNFc SPC
NICE TA276: Cystic fibrosis (pseudomonas lung infection) - colistimethate sodium and tobramycin
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.