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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 12 - Ear, nose and oropharynx 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
12.02.03 Nasal preparations for infection
12.02.03 Nasal Staphylococci

Mupirocin 2% (Bactroban Nasal®)
(Nasal Ointment)

GREEN
First Choice

Apply to both nostrils twice a day for 5 days.

BNF BNFc SPC

Octenisan
(Nasal Gel)

GREEN
Second Choice

MRSA protocol 1 (if mupirocin not unavailable):

Octenisan antimicrobial wash lotion 1 application OM for 5 doses

Octenisan nasal gel 1 application BD for 5 days

BNF BNFc SPC

Chlorhexidine Hydrochloride with Neomycin Suphate (Naseptin®)

GREEN
Third Choice

Chlorhexidine 0.1%/Neomycin Sulphate 0.5%

MRSA protocol 2 (if Octenisan gel and mupirocin are unavailable):

Octenisan antimicrobial wash lotion 1 application OM for 10 doses

Naseptin cream 1 application QDS for 10 days

 

Update May 2023: The product has now been reformulated with medium-chain triglycerides replacing the arachis oil (peanut oil) excipient. Contraindications for use in people with peanut and/or soya have therefore been removed. However, please note that stock containing arachis oil may still be available in community pharmacies and caution should still be exercised in prescribing this for people with peanut allergy.

BNF BNFc SPC
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.