netFormulary Harrogate & Rural District Formulary NHS
Harrogate & District NHS Foundation Trust
Harrogate & Rural District Clinical Commissioning Group
 Formulary Chapter 5: Infections - Full Chapter

To promote the appropriate use of antibiotics
-To avoid unnecessarily long courses
-to prevent the emergence and propogation of antimicrobial resistance
-to minimise the risk of Clostridium difficile infection

Antimicrobial Prescribing Guidelines - Primary Care

Antimicrobial Prescribing Guidelines - Adults Summary

Treatment          Prophylaxis
Bone & Joint Infections     Rationale for Prophylaxis
CNS Infections          Gentamicin Prophylaxis Dosing
Endocarditis          Cardiology Procedures
ENT Infections           General Surgery
Eye Infections                          Head & Neck Surgery
& Orbital Cellulitis               Obstetrics & Gynaecology
Gastrointestinal Infections   Orthopaedic Surgery
Genital Tract Infections     Urological Surgery
Respiratory Infections            
Skin & Soft Tissue Infections
& Diabetic Foot Infections
ED Supplement - Cellulitis

Antimicrobial Prescribing Guidelines - Paediatrics
Orbital Cellulitis Guidelines
Neonatal sepsis - dosing chart
Neonatal sepsis guidelines (with meningitis)
IV antibiotic doses used on SCBU - quick reference guide
IV antibiotic doses in children from 1 month to 16 years - quick reference guide

Penicillin Allergy
For guidelines for prescribing in patients with documented allergy to penicillins, click here.

Dose Recommendations
- The doses recommended in the guidelines are for guidance ONLY.
- For elderly/renally-impaired patients, consult current BNF, ward pharmacist or Medicines Information (Ext: 3084)

Antimicrobial Medicines Code
- The Antimicrobial Medicines Code sets out the roles and responsibilities for healthcare professionals involved in the prescribing, supply and administration of antibiotics.
- The full version of the Antimicrobial Medicines Code can be found by clicking here
- Summary of Prescribing Standards (Section 3)
   - Is an antimicrobial indicated?
   - Ensure appropriate specimens are taken prior to starting therapy.
   - Choice of antibiotic should be based on local guidelines.
   - Include the duration (or review date) and the indication for treatment on the prescription chart
   - Review the need for antibiotics regularly, including switching from IV to PO treatment, according to the policy. Click here for details of the IV to PO Switch Policy.

OPAT Registration Form and Pathway

Microbiology Investigations
When ordering microbiology investigations please give relevent clinical details. The ways in which specimens are processed, the interpretation of the results and reporting of antimicrobial susceptibilities will vary to a very great extent, on the clinical details given.

CIVAS order form

Chapter Links...
 Details...  Expand sub section  Broad-spectrum penicillins
View adult BNF View SPC online View childrens BNF
Capsules 250mg & 500mg
Syrup 125mg/5ml & 250mg/5ml
Injection 250mg, 500mg and 1g powder (hospital only) 
Link  HDFT - Cellulitis Treatment
Link  HDFT - Exacerbation of COPD
Link  HDFT - Treatment of Community Acquired Pneumonia
View adult BNF View SPC online View childrens BNF  Track Changes
Restricted Drug Restricted
Tablets 375mg & 625mg
Syrup 125/31mg & 250/62mg
Injection 1.2g powder

Should be prescribed as "Amoxicillin/Clavulanate" to identify it as a penicillin.

Animal/Human Bites
Open fractures 
Link  HDFT - Treatment of Community Acquired Pneumonia
 Non Formulary Items

View adult BNF View SPC online View childrens BNF
Non Formulary

View adult BNF View SPC online View childrens BNF
Non Formulary
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
Track Changes
Display tracking information
click to search
Link to adult BNF
click to search
Link to children's BNF
click to search
Link to SPCs
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHS England

Traffic Light Status Information

Status Description


Medicines which are suitable to be prescribed in primary care only after specialist recommendation. Ongoing prescribing by primary care includes titration of dose and assessment of efficacy. There is no need for ongoing monitoring other than for general adverse effects as listed in the BNF & SPC.  

Amber Shared Care

Medicines which are suitable to be prescribed in primary care only after specialist recommendation only under a shared care protocol once the patient has been stabilised. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must be approved by the Harrogate & Rurual District Area Prescribing Committee (HaRD APC).   


Medicines which the Harrogate & Rural District Area Prescribing Committee (HaRD APC) has reviewed and does not recommend for use at present based on a review of clinical and/or cost effectiveness data.   


Medicines suitable for routine use and can be prescribed within primary care within their licensed indication in accordance with nationally recognised formularies e.g. BNF, BNF for Children, Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.  


Medicines which the Harrogate & Rural District Area Prescribing Committee (HaRD APC) have not yet reviewed.   


Medicines for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician. The drug should be supplied by the hospital for the duration of the treatment course. Primary care prescriber initiation or continuation of treatemnt is not recommended.