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5 Drugs Used in Infections

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5 Drugs Used in Infections 5. Drugs used in the treatment of Infections 5.1.1 Penicillins 5.1.1.1 Benzylpenicillin and benzylpenicillin phenoxymethylpenicillin phenoxymethylpenicillin procaine benzylpenicillin (unlicensed - Sexual Health directorate only ) benzathine benzylpenicillin (unlicensed - Sexual Health directorate only ) 5.1.1.2 Penicillinase-resistant penicillins flucloxacillin temocillin (on the recommendation of microbiologist following sensitivities – for complicated 5.1.1.3 Broad spectrum penicillins UTI) amoxicillin 5.1.1.4 Antipseudomonal penicillins co-amoxiclav (A&E for dog/human bites, Breast Care and ENT only ) 5.1.2 Cephalosporins, cephamycins & other piperacillin plus tazobactam ( Tazocin® ) beta-lactam antibiotics cefadroxil (oral only) cefixime (oral only for Sexual Health directorate) cefalexin cefotaxime ( on the recommendation of a duty microbiologist only e xcept Neonates and Neurosurgery ) ceftazidime ceftriaxone cefuroxime (iv only ) Other beta lactam antibiotics aztreonam (requires Microbiology approval ) ertapenem (on the recommendation of a consultant microbiologist for HOPT patients only - see Flowchart for advice on selection of carbapenems ) imipenem ( on the recommendation of a duty microbiologist only - see Flowchart for advice on selection of carbapenems ) meropenem (on the recommendation of a duty microbiologist only - see Flowchart for advice on 5.1.3 Tetracyclines selection of carbapenems ) demeclocycline doxycycline (oral) doxycycline (Doxycyclin-ratiopharm® SF injection - Respiratory Team only for pleurodesis) lymecycline (Dermatology only ) 5.1.4 Aminoglycosides minocycline (Aknemin® - Dermatology only ) Tigecycline (for use by microbiology consultant only) amikacin ( on the recommendation of a duty microbiologist only) gentamicin 5.1.5 Macrolides neomycin netilmicin (Neonatal unit and Nephrology only ) azithromycin (GUM clinic ) clarithromycin (iv only ) clarithromycin (oral in Gastroenterology directorate only and for treatment of diabetic foot 5.1.6 Clindamycin infections - see Antibiotic Guidelines ) erythromycin 5.1.7 Some other antibacterials clindamycin chloramphenicol colistin daptomycin (on the recommendation of a consultant microbiologist only) linezolid ( on the recommendation of a consultant microbiologist only) sodium fusidate quinupristin-dalfopristin (on the recommendation of a duty microbiologist only) Fosfomycin – unlicensed (on recommendation of microbiologist following sensitivities for complicated UTI ) 5.1.8 Sulphonamides and trimethoprim teicoplanin vancomycin 5.1.9 Antituberculous drugs sulfadiazine (iv only ) trimethoprim ethambutol isoniazid pyrazinamide 5.1.11 Metronidazole rifampicin Rifinah® 5.1.12 Quinolones streptomycin ( named patient drug) metronidazole 5.1.13 Urinary tract infections ciprofloxacin levofloxacin nalidixic acid nitrofurantoin 5.2 Antifungal drugs amphotericin ( Abelcet® and Fungizone® ) caspofungin (on the recommendation of a duty microbiologist only) fluconazole flucytosine itraconazole (on the recommendation of a duty microbiologist only e xcept Dermatology, Obs & Gynae, Haematology & Oncology or GUM Clinic ) ketoconazole (Palliative care only ) miconazole nystatin posaconazole for zygomycetes and aspergillosis unresponsive to, or in patients intolerant of/unsuitable for voriconazole or amphotericin B) (Microbiologist advice only) terbinafine ( Dermatology only ) voriconazole (on the recommendation of a duty microbiologist only) For topical antifungals see 13.10.2 5.3 Antiviral drugs aciclovir amantadine (not for Influenza A prophylaxis ) ganciclovir palivizumab (Neonatology only ) oseltamivir (use in accordance with Trust Influenza A guidelines and NICE guidance ) For advice on the treatment of HIV infection, contact GUM or Microbiology. The North Manchester Guidelines for Drug therapy in HIV Disease have been approved for use within SRHT. Anti-retrovirals approved for use within the Trust are listed in the attached documents . 5.4 Antiprotozoal drugs 5.4.1 Antimalarials chloroquine primaquine quinine 5.4.2 Amoebicides metronidazole 5.4.3Trichomonacides metronidazole 5.4.4 Antigiardial drugs metronidazole 5.4.8 Drugs for pneumocystis pneumonia co-trimoxazole (on the recommendation of a duty microbiologist only except GUM clinic ) pentamidine (on the recommendation of a duty microbiologist only except GUM clinic ) 5.5. Anthelmintics 5.5.1 Drugs for threadworms mebendazole piperazine 5.5.2 Ascaricides mebendazole piperazine 5.5.3 Drugs for tapeworm infections niclosamide (named patient drug) 5.5.8 Drugs for strongyloidiasis tiabendazole (named patient drug - consultant dermatologist only ) 5.6 Miscellaneous 5.6.1 Probiotics VSL3® probiotic (Consultant gastroenterologist only for the treatment of pouchitis and intractable colitis) .
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