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The most recent Guidelines for Primary and Secondary Care can be found below: 

Antimicrobial Guidelines in Primary Care

Antimicrobial Guidelines for Secondary Care

For further guidance refer to local Consultant Microbiologists or contact your pharmacist.

COVID-19 Treatments
RED    Paxlovid  COVID-19 in patients who do not require oxygen supplementation and are at an increased risk of severe COVID-
            19 infection 
RED    Molnupiravir mild to moderate Covid-19 [with at least one risk factor of developing severe illness]
RED    Remdesivir 100mg vial: for patients hospitalised due to Covid-19 (adults and adolescents 12 years and older)
RED    Baricitinib:  a treatment option for adults and children aged over 2 years hospitalised with Covid-19 

        5.3.1 HIV Infection
        Please refer to Lancashire Formulary for AntiRetroviral Therapy (ART) - click here
        Nucleoside reverse transcriptase inhibitors
        RED          Abacavir tablets 300mg                                                                                                                  NHS England Commissioned 
        RED          Abacavir with Lamivudine tablets 300mg, 600mg ( Kivexa®)                                                          NHS England Commissioned
        RED           Zidovudine 300mg, lamivudine 150mg (Combivir®)                                                                         NHS England Commissioned
        RED           Didanosine  tablets 25mg,  capsules e/c 250mg, 400mg                                                        NHS England Commissioned   
        RED           Lamivudine tablets 100mg,150mg                                                                                              NHS England Commissioned 
        RED           Tenofovir tablets 245mg                                                                                                               NHS England Commissioned  
        RED           Tenovir 245mg, emtricitabine 200mg tablets (Truvada®)                                                               NHS England Commissioned
        RED           Zidovudine  capsules 100mg, 250mg/  syrup 50mg/5mL                                                        NHS England Commissioned   
        Integrase Strand Transfer Inhibitors  (INSTI)
        RED             Cabotegravir with rilpivirine (Vocabria® with Rekambys®)                                                    NHS England Commissioned)
        NICE TA757 Cabotegravir with rilpivirine is recommended, within its marketing authorisation, as an option for treating HIV‑1 
                             infection in adults:
                               > with virological suppression (HIV-1 RNA fewer than 50copies/ml) on a stable antiretroviral regimen and
                               > without any evidence of viral resistance to, and no previous virological failure with, any non-nucleoside reverse 
                                  transcriptase inhibitors or integrase inhibitors.
        Protease inhibitors
        RED           Atazanavir capsules 150mg, 200mg, 300mg  [Second line use only]                                       (NHS England Commissioned)
        RED           Darunavir tablets 75mg, 150mg, 400mg, 600mg                                                                     (NHS England Commissioned) 
                          oral suspension 100mg/mL  [Second line use only]
        RED           Fosamprenavir tablets 700mg                                                                                                     (NHS England Commissioned) 
        RED          Glecaprevir with pibrentasvir   NICE TA499                                                                               (NHS England Commissioned)
        RED          Indinavir capsules 200mg                                                                                                            (NHS England Commissioned) 
        RED          Kaletra® tablets (lopinavir 200mg, ritonavir 50mg)                                                                 (NHS England Commissioned)   
        RED          Nelfinavir tablets 250mg                                                                                                              (NHS England Commissioned)   
        RED          Ritonavir capsules 100mg                                                                                                            (NHS England Commissioned)  
        RED          Saquinavir capsules 200mg                                                                                                         (NHS England Commissioned)   
        RED          Elbasvir-grazoprevir tablets 50mg, 100mg   NICE TA 413                                                        (NHS England Commissioned)
        Non-nucleoside reverse transcriptase inhibitors
        RED          Efavirenz, tablets 600mg, capsules 200mg                                                                                         (NHS England Commissioned)   
        RED          Etravirine tablets 100mg, 200mg  [Third line use only]                                                            (NHS England Commissioned)   
        RED          Nevirapine tablets 200mg                                                                                                           (NHS England Commissioned) 
        Other antiretrovirals
        RED          Raltegravir tablets 400mg                                                                                                           (NHS England Commissioned)   
        RED          Maraviroc tablets 150mg, 300mg (Celsentri®)                                                                                  (NHS England Commissioned)

        5.3.2 Herpesvirus infections Herpes simplex and varicella-zoster infection
        GREEN      Aciclovir
                          tablets 200mg, 400mg, 800mg
                          suspension 200mg/5mL
                          injection 250mg/10mL, 500mg/20mL, 1000mg/40mL
        GREEN     Valaciclovir tablets 500mg - 2nd line option, on advice of microbiology, when aciclovir is not tolerated or ineffective.
        AMBER     Famciclovir (second line use only)
                          tablets 125mg, 250mg, 750mg
 Cytomegalovirus infection
        Valganciclovir is used in the treatment of reactivated CMV in immunosuppressed patients treated with MabCampath® as per
        protocols at Manchester Royal Infirmary.
        RED           Ganciclovir injection 500mg vial                                                                                                  (NHS England Commissioned)
        RED           Valganciclovir tablets 450mg                                                                                                       (NHS England Commissioned) 
        RED           Foscarnet Sodium (Foscavir®)   
                          (cytomegalovirus retinitis in AIDS patients)                                                                                   (NHS England Commissioned)  
        RED            Cidofovir capsules 250mg (Vistide®)    
                          (cytomegalovirus retinitis in AIDS patients)                                                                                   (NHS England Commissioned) 

        RED              Letermovir tablets 240mg (Prevymis ▼)
        NICE TA591  recommended as an option for preventing cytomegalovirus reactivation and disease after an allogeneic 
                             haematopoietic stem cell transplant in adults who are seropositive for CMV.                NHS England Commissioned
          RED          Maribavir (Livtencity)
         NICE TA860  Recommended, within its marketing authorisation, as an option for treating cytomegalovirus infection that is        
                              refractory to treatment including cidofovir, foscarnet, ganciclovir or valganciclovir in adults who have had a 
                             haematopoietic stem cell transplant or solid organ transplant. It is recommended only  if the company provides it                                 according to the commercial arrangement.                                                                           NHS England Commissioned

        Remdesivir for patients hospitalised due to Covid-19 (adults and adolescents 12 years and older)
        RED             Remdesivir 100mg powder for concentration for solution for infusion [Veklury]
        Paxlovid for patients who do not require oxygen supplementation and are at an increased risk of severe COVID-19 infection 
        RED             Paxlovid 150mg, 300mg tablets
        Molnupiravir mild to moderate Covid-19 [with at least one risk factor of developing severe illness]
        RED             Molnupiravir 200mg capsules [Lagevrio]
       5.3.3 Viral Hepatitis
        As per NICE guidance – see BNF.
        RED         Adefovir dipivoxil tablets 10mg (Herpsera®)          (NHS England Commissioned)   
        Entecavir - within its marketing authorisation, is recommended as an option for the treatment of people with chronic HBeAg-
        positive or HBeAg-negative hepatitis B in whom antiviral treatment is indicated. This guidance does not apply to people with 
        chronic hepatitis B who also have hepatitis C, hepatitis D or HIV. 
        RED          Entecavir tablets 500microgram, 1mg /  oral solution 50microgram/ml                               (NHS England Commissioned) 
        RED          Tenofovir tablets 245mg 
        NICE TAG252 and NICE TAG253 approve the use of Telaprevir and Boceprevir for the treatment of Hepatitis C,  genotype 1 
        RED         Telaprevir (Invico®) tablets                                                                                                            (NHS England Commissioned)   
        RED         Boceprevir (Victrelis®) tablets                                                                                                       (NHS England Commissioned)     
        NICE TAG300 recommends the use of Peginterferon alfa in combination with ribavirin as an option to treat chronic hepatitis C
        in children and young people.
        RED          Peginterferon alfa and ribavirin in combination                                                                       (NHS England Commissioned)
 Chronic Hepatitis C
        NHS England have issued a policy statement for treatment of chronic Hepatitis C in patients with cirrhosis which sets out
        treatments that will be routinely commissioned.  The statement is available here.
        The statement supports the use of Viekirax and Exviera and this is acknowledged.
        Sofosbuvir -is recommended as an option for treating chronic hepatitis C in adults, as specified in  NICE TA330 
        RED          Sofosbuvir (Sovaldi®) tablets                                                                                                        (NHS England Commissioned) 
        Sofosbuvir-velpatasvir - is recommended as an option for treating chronic hepatitis C in adults, as specified in 
        attached table, only if the company provides the drug with the discount agreed in the simple discount agreement. NICE TA430 
        RED          Sofosbuvir-velpatasvir (Epclusa)                                                                                                   (NHS England Commissioned)  
        RED          Sofosbuvir-velpatasvir-voxilaprevir is recommended as an option for treating chronic hepatitis C in adults, only if it i
                         is used as specified in the attached table, and the company provides the drug at the same price or lower than that 
                         agreed with the Commercial Medicines Unit as per NICE TA507                                             (NHS England Commissioned)  
        Simeprevir - in combination with peginterferon alfa nd ribavirin is recommended as a possible treatment for adults with 
        genotype1 or 4 chronic hepatitis C - NICE TA331 
        RED          Simeprevir (Olysio®) capsules                                                                                                      (NHS England Commissioned)    
        RED          Ledispar-sofosbuvir (Harvoni®)   tablets 90mg, 400mg                                                          (NHS England Commissioned)   
        Daclatasvir - is recommended as a possible treatment for adults with some types (called genotypes) of chronic hepatitis C , 
        depending on their level of fibrosis. NICE TA364 
        RED        Daclatasvir (Daklinza®tablets 30mg, 60mg                                                                                (NHS England Commissioned)
        Ombitasvir- paritaprevir-ritonavir with or without dasabuvir is recommended, within its marketing authorisation, as an 
        option for treating genotype 1 or 4 chronic hepatitis in adults - NICE TA365 
        RED          Ombitasvir–paritaprevir–ritonavir (Viekirax®) tablets 12.5mg, 75mg, 50mg                        (NHS England Commissioned)  

        RED          Ribavirin tablets 200mg                                                                                                                 (NHS England Commissioned)   

        5.3.4 Influenza
        Oseltamavir and zanamivir are to be used in line with NICE guidance and local emergency planning agreements.  
        Endorse prescription SLS.
        GREEN     Oseltamivir, capsules 75mg, suspension 60mg/5mL
        GREEN     Zanamivir inhaler 5mg blisters x 4
        5.3.5 Respiratory syncytial virus
        Palivizumab is to be used in line with National Joint Committee of Vaccination and Immunisation guidance in the following
             1. Children under the age of 2 years with chronic lung disease who
                       >     have received oxygen for >28 days after birth;
                       >     are receiving home oxygen therapy
             2. Infants less than 6 months of age who have left to right shunt haemodynamically significant congenital heart disease 
            and/or pulmonary hypertension.  
        Supply of palivizumab should always be from pharmacy to individual patients; it should never be issued as stock.  This
        allows recharging of the costs of palivizumab to the CCGs under ‘payment by results’ by allowing the tracing of all supplies.
        RED          Palivizumab injection 50mg, 100mg                                                                                                    (NHS England Commissioned)  


All material in this section is aimed at health care professionals, but is information currently held in the public domain, members of the
 public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service
  Email: info.elmmb@nhs.net
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