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Birmingham, Sandwell, Solihull and environs APC Formulary
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 Formulary Chapter 5: Infections - Full Chapter
Notes:
Broad-spectrum antibiotics SHOULD NOT be used outside of the Primary Care Antimicrobial Guidelines, unless recommended by a specialist, in line with antimicrobial stewardship.
Please be aware that all GREEN drugs are only green if used in line with antimicrobial guidelines. 
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05.01.05  Expand sub section  Macrolides
Azithromycin
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Green Traffic Light  Tablets/ suspension. When used in line with Primary care antimicrobial guidelines


   Tablets only. For COPD or bronchiectasis patients who have ≥3 exacerbations per year. Off-label use. Supported by RICaD and Guidelines on Respiratory use of long term azithromycin in adults

  • Do not prescribe azithromycin as stand-alone medication for the indication of gonorrhoea. Refer to GUM clinic for IM ceftriaxone as per current UK guidelines.
 
Link  Antimicrobial Primary Care Guidelines 2019 - Birmingham Antimicrobial Advisory Committee
Link  Chief Medical Officer letter to General Practitioners (December 2015)
   
Azithromycin
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Red
  • Do not prescribe azithromycin as stand-alone medication for the indication of gonorrhoea. Refer to GUM clinic for IM ceftriaxone as per current UK guidelines.
 
Link  Chief Medical Officer letter to General Practitioners (December 2015)
   
Clarithromycin (oral presentations)
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Green
 
Link  Antimicrobial Primary Care Guidelines 2019 - Birmingham Antimicrobial Advisory Committee
   
Clarithromycin (injection)
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Red
 
   
Erythromycin (tablets)
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Green
 
Link  Antimicrobial Primary Care Guidelines 2019 - Birmingham Antimicrobial Advisory Committee
Link  Medicines Q&A: Is there an interaction between erythromycin and statins?
   
Erythromycin Ethyl succinate (oral suspension)
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Green
 
Link  Antimicrobial Primary Care Guidelines 2019 - Birmingham Antimicrobial Advisory Committee
Link  Medicines Q&A: Is there an interaction between erythromycin and statins?
   
Erythromycin Lactobionate (Injection)
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Red
 
   
 ....
 Non Formulary Items
Telithromycin  (Ketek®)

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
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Link to adult BNF
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Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Prescribing in children

The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.

The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
  

Green

Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians.   

Amber Initiation

Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry.  

Amber Recommended

Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.  

Amber SC

Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry.  

Red

Medicines for initiation and maintenance prescribing by Specialists only.  

Black

Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

Grey

Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.  

The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest.  

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