Antimicrobial restrictions
Queensland Children’s Hospital Antimicrobial formulary
The Queensland Children’s Hospital (QCH) antimicrobial restriction procedure is a core component of the Antimicrobial stewardship program.
It is the responsibility of prescribing medical officer to obtain appropriate approval for antimicrobials.
The following list of antimicrobials should be followed in conjunction with current List of Approved Medicines (LAM).
All other antimicrobials not listed on this document or used for off label/ off license indications, require approval before use unless specific arrangements have been made with your department.
QCH Antimicrobial Traffic Light System
The antimicrobial formulary is divided into the following three categories:
Unrestricted (green)

Restricted (amber)

Where approval is required, the Prescriber will contact the Infectious Diseases consultant who will consider the antimicrobial’s use.
Please document:
- The indication
- Name of the authorising clinician and unique ID approval number must be annotated on the medication chart (or prescription).
For SAS medications, you must also complete the following forms to submit to pharmacy and infectious diseases consultant on service:
Restricted (red)

Please document:
- The indication
- Name of the authorising clinician and unique ID approval number must be annotated on the medication chart (or prescription).
For SAS medications, you must also complete the following two forms and submit the to pharmacy and Infectious diseases consultant on service:
Search antimicrobial formulary (generic name)
Antimicrobial | Colour code |
---|---|
Amoxycillin (Amoxicillin) (IV and PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist or low risk oral challenge as per CHQ-GDL-01076 Paediatric antibiotic allergy assessment, testing and de-labelling. | Green |
Amoxycillin / Clavulanic acid (Amoxicillin / Clavulanic acid) (PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist or low risk oral challenge as per CHQ-GDL-01076 Paediatric antibiotic allergy assessment, testing and de-labelling. | Green |
Amphotericin B lozenges (PO) | Green |
Ampicillin (IV)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist. | Green |
Benzathine penicillin (IM) | Green |
Benzylpenicillin (IV)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist. | Green |
Cefaclor (PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist. | Green |
Cephalexin (PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist or low risk oral challenge as per CHQ-GDL-01076 Paediatric antibiotic allergy assessment, testing and de-labelling. | Green |
Cephazolin (Cefazolin) IV (Inpatient)Pre-approved for first dose challenge, IDT or SPT by Paediatric Immunologist/Allergist. Desensitisation – ID approval required. | Green |
Chloramphenicol (eye drops) | Green |
Clotrimazole (topical) | Green |
Dicloxacillin (PO)Pre-approved for first dose challenge, IDT or SPT by Paediatric Immunologist/Allergist. Desensitisation – ID approval required. | Green |
Flucloxacillin (IV and PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist or low risk oral challenge as per CHQ-GDL-01076 Paediatric antibiotic allergy assessment, testing and de-labelling. | Green |
Framycetin - Gramicidin - Dexamethasone (Sofradex) 8mL Ear drops | Green |
Metronidazole (PO and IV)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist. | Green |
Miconazole (topical cream) | Green |
Nitrofurantoin (PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist. | Green |
Nystatin (PO and topical) | Green |
Permethrin (topical) | Green |
Phenoxymethylpenicillin (PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist or low risk oral challenge as per CHQ-GDL-01076 Paediatric antibiotic allergy assessment, testing and de-labelling. | Green |
Pyrantel (PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist. | Green |
Roxithromycin (PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist. | Green |
Tinidazole (PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist. | Green |
Trimethoprim (PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist. | Green |
Trimethoprim / Sulfamethoxazole (PO)Pre-approved for first dose challenge, IDT or SPT and desensitisation by Paediatric Immunologist/Allergist. | Green |
Aciclovir (PO and IV)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. IV Aciclovir not suitable for IDT or SPT due to alkaline pH. Oral
or
| Amber |
Aciclovir cold sore ointment
| Amber |
Aciclovir Eye Ointment
| Amber |
Albendazole (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Amoxicillin/ Clavulanic acid (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Amoxycillin, Clarithromycin and Esomeprazole (Triple therapy)
| Amber |
Amphotericin B Liposomal (IV)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
or
| Amber |
Azithromycin (IV)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Azithromycin (tablets and suspension) (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Cefazolin 5 % eye drops
| Amber |
Cefepime (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Cefotaxime (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
or
or
All other indications require IMPS approval | Amber |
Cefoxitin (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Ceftazidime (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Ceftazidime intravitreal injection
| Amber |
Ceftriaxone (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
or
All other indications require IMPS approval | Amber |
Ceftriaxone IV (HITH)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. 72 hours approval for HITH for the following indications according to the
target="_blank">CHQ-GDL-63012 CHQ Hospital in the Home antibiotic guidelines in infants (>3 months of age) and children deemed to be unsuitable for oral antimicrobial therapy:
| Amber |
Cefuroxime (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Chloramphenicol eye ointment
| Amber |
Cephazolin (Cefazolin) Intravitreal and intracameral injection
| Amber |
Cephazolin (Cefazolin) IV (HITH)72 hours approval for HITH for the following indications according to the CHQ-GDL-63012 CHQ Hospital in the Home antibiotic guidelines in infants (>3 months of age) and children deemed to be unsuitable for oral antimicrobial therapy:
| Amber |
Ciprofloxacin (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
or
| Amber |
Ciprofloxacin ear/eye drops
or Ear drops: On advice from ENT consultant for the treatment of:
| Amber |
Clindamycin (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. Approval required after 48 hours therapy for:
| Amber |
Colistin (nebulised)
| Amber |
Dapsone (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. For use by haematology/oncology as alternative to trimethoprim/sulfamethoxazole as PCP prophylaxis | Amber |
Doxycycline (IV - SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation.
| Amber |
Doxycycline (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Erythromycin (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. IMPS approval required for all off label/off license indications | Amber |
Famciclovir (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
All other indications require IMPS Approval | Amber |
Fluconazole (PO and IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Gentamicin (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. Approval required after 72 hours therapy for:
| Amber |
Gentamicin eye dropsOn advice from Ophthalmology team | Amber |
Gentamicin IV (HITH)72 hours approval for HITH for the following indications according to the CHQ-GDL-63012 CHQ Hospital in the Home antibiotic guidelines in infants (>3 months of age) and children deemed to be unsuitable for oral antimicrobial therapy:
| Amber |
Griseofulvin (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Hydroxychloroquine (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. Restricted to prescribing by the following authorised specialists:
For further information refer to the List of Approved Medicines (LAM) homepage at: https://qheps.health.qld.gov.au/medicines/services/lam. Recommendations from the Australian guidelines for the clinical care of people with COVID-19 https://app.magicapp.org/#/guideline/L4Q5An/section/j1bkzL
| Amber |
Itraconazole (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
or
| Amber |
Lincomycin (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. Approval required after 48 hours therapy for:
| Amber |
Mebendazole (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Minocycline (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Mupirocin (intranasal ointment)
| Amber |
Mupirocin (topical ointment)
| Amber |
Neomycin (PO)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation.
| Amber |
Ofloxacin eye drops
| Amber |
Oseltamivir (PO)On the advice of an Infectious Diseases Physician or a Clinical Microbiologist or in accordance with an Infectious Diseases / Clinical Microbiology approved influenza treatment protocol or as per the QLD Health List of approved medicines | Amber |
Piperacillin/ Tazobactam (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
or
or
or
| Amber |
Posaconazole (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Rifampicin (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Teicoplanin (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Terbinafine (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Tobramycin (inhaled – TOBI podhaler)
| Amber |
Tobramycin (IV and nebulised)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. Intravenous:
Nebulised:
| Amber |
Tobramycin Eye drops and eye ointment
| Amber |
Trimethoprim/ Sulfamethoxazole (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. Approval required after 48hours for:
| Amber |
Valaciclovir (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. Oral
On the advice of Consultant Specialist Staff for:
| Amber |
ValGANciclovir (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
Vancomycin (IV)Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required. For use in accordance with the:
Approval required after 72 hours therapy for:
| Amber |
Vancomycin Intravitreal and intracameral Injection
| Amber |
Voriconazole (PO)Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.
| Amber |
AbacavirID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. High risk for hypersensitivity reactions. | Red |
Adefovir (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Amikacin (IV and nebulised)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Amorolfine (nail lacquer 5%) | Red |
Amphotericin B lipid complex (Abelcet ) (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Amphotericin (Fungizone ) (SAS) IVID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Anidulafungin (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Artemether+Lumefantrine (Riamet) (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Artesunate (SAS) IVID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
AtazanavirID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Atovaquone (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Atovaquone/ Proguanil (Malarone ) (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Aztreonam (IV and nebulised)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Bacitracin (topical) (SAS) | Red |
Bedaquiline (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Benznidazole (PO) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Brincidofovir (Compassionate use/SAS) (PO)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Capreomycin (SAS) (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Casirivimab-ImdevimabFor use within CHQ under the guidance of Paediatric ID consultant as per the criteria for access to Casirivimab-Imdevimab from the National Medical Stockpile. CGOV IPA may be required. | Red |
Caspofungin (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Cefpodoxime (PO) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ceftolazone/Tazobactam (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ceftazidime/Avibactam (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ceftaroline (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Cephalothin (Cefalotin) eye drops (Cefalotin) – temporary shortage until 2021
| Red |
Chloramphenicol (SAS) (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Chloroquine (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Cidofovir (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ciprofloxacin (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Clofazimine (PO) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Colistin (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ciprofloxacin/hydrocortisone (ear drops) | Red |
Clarithromycin (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Clindamycin (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Cycloserine (SAS) (PO)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
DaclatasvirID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Daptomycin (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Darunavir (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. High risk of hypersensitivity in patients with a sulpha allergy. | Red |
Delamanid (PO) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Dicloxacillin (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
DolutegravirID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Doripenem (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
EfavirenzID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Elvitegravir (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
EmtricitabineID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
EnfuviritideID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Entecavir (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ethambutol (PO) and (SAS – IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ertapenem (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Erythromycin (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ethionamide (PO) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Fidaxomicin (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Fluconazole (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Flucytosine (SAS) (IV and PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Fosfomycin (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Fosfomycin IV (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Foscarnet (IV) | Red |
Fusidic acid (sodium fusidate) (PO)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ganciclovir (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
HITH (Hospital in the home IV antimicrobials)CF patients receiving Tobramycin and Piperacillin/Tazobactam or Ceftazidime for (HITH) according to the CHQ-GDL-01073 Empirical antimicrobial therapy for children with Cystic Fibrosis Non-CF bronchiectasis patients receiving Ceftriaxone according to the CHQ-GDL-01072 Empirical antimicrobial therapy for children with Non-Cystic Fibrosis Bronchiectasis For the following indications according to the CHQ-GDL-63012 CHQ Hospital in the Home antibiotic guidelines in infants (>3 months of age) and children deemed to be unsuitable for oral antimicrobial therapy:
see QCH Antimicrobial Formulary. Written confirmation of Infectious Diseases approval needs to accompany (CHQatHome) referral form. | Red |
Imipenem/cilastatin (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Isavuconazole (IV/oral)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Isoniazid (PO) (SAS – IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ivermectin (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ketoconazole (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
LamivudineID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ledipasvir with SofosbuvirID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
LetermovirID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Levofloxacin IV/PO (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Linezolid (PO and IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Lopinavir/RitonavirID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Maraviroc (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Mefloquine (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Miltefosine (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Moxifloxacin (PO and IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Meropenem/Vaborbactam (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Meropenem (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Methenamine hippurateID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Micafungin (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Nalidixic acid (PO) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Natamycin eye drops (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Netilmicin (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
NevirapineID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Niclosamide (PO) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Nitazoxanide (SAS) (PO)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Norfloxacin (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Palivizumab (IM) | Red |
Paromomycin (SAS) (PO and topical)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Para-Aminosalicylic acid (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Pentamidine (IV and nebulised)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Peramivir IVID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Pivmecillinam (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Polymyxin B (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Posaconazole (IV) (compassionate use)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Praziquantel (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Pretomanid (PO) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Primaquine (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Pristinamycin (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Pylera ( Bismuth, Metronidazole, Tetracycline) (SAS) | Red |
Pyrazinamide (PO) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Pyrimethamine (PO)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Quinine (IV and PO)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Quinupristin/Dalfopristin (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Raltegravir (PO)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
RemdesivirFor use within CHQ under the guidance of Paediatric ID consultant as per the criteria for access to Remdesivir from the National Medical Stockpile. CGOV IPA may be required. | Red |
Ribavirin (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ribavirin (IV) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Rifabutin (PO)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Rifampicin (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Rifapentine (PO) (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Rifaximin (SAS – suspension) (PO)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Rilpirivine (with tenofovir and emtricitabine) (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
SarilumabFor use within CHQ under the guidance of Paediatric ID consultant as per the criteria for access to Sarilumab from the National Medical Stockpile. CGOV IPA may be required. | Red |
SofosbuvirID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
SotrovimabFor use within CHQ under the guidance of Paediatric ID consultant as per the criteria for access to Sotrovimab from the National Medical Stockpile. CGOV IPA may be required. | Red |
Streptomycin (SAS) (IM)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Sulfadiazine (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Tafenoquine (PO)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Taurolidine/citrate antiseptic lock (Taurolock) | Red |
Tedizolid (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Telithromycin (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
TenofovirID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Tetracycline (SAS)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Ticarcillin/Clavulanate (IV)Drug discontinued in 2018. | Red |
Triclosan | Red |
Tigecycline (IV)ID approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Vancomycin (PO)
| Red |
Voriconazole Intravitreal injection | Red |
Voriconazole (IV)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Voriconazole (eye drops) | Red |
Zanamavir (inhaled) (IV- compassionate use only)ID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
ZidovudineID approval and SAS approval required for Paediatric Immunologist/Allergist-led first dose challenge, SPT or IDT and desensitisation. | Red |
Clinical scenarios involving antimicrobials that require ID approval
- All patients requiring Hospital in the Home (HITH) Parenteral Antibiotics (excluding CF patients receiving Tobramycin and Piperacillin/Tazobactam for HITH OR non-CF bronchiectasis patients receiving Ceftriaxone- see QCH Antimicrobial formulary)
- Antimicrobials which may require special aseptic compounding
- Antimicrobial eye drops e.g. Ceftazidime, Cephazolin, Vancomycin, Voriconazole, Natamycin
- Antimicrobials for Intravitreal injections e.g. Amphotericin, Voriconazole, Ceftazidime and Vancomycin;
- Antimicrobials for Intrathecal or Intraventricular administration e.g. Vancomycin, Gentamicin.
Authorising infectious diseases physicians and clinical microbiologists at QCH
Use of a restricted antimicrobial at QCH can be authorised by the clinicians listed below:
- Dr Julia Clark
- Dr Clare Nourse
- Dr Meryta May
- Dr Vikram Vaska
- Dr Sophie Wen
- ID Fellow/Registrar
- Clinical Microbiologist: Dr Claire Heney
CHQ medication approval process
Antimicrobial supply for inpatients
Pharmacy may provide 24 hours initial supply of antibiotics to avoid unnecessary delay in treatment. Exceptions may apply.
Antimicrobial supply for outpatients
ID consultation and approval is required before antimicrobial supply will be dispensed.
Further supply will be dependent on receipt of ID approval. If no approval is forthcoming, this will be escalated to the primary treating Consultant, IMPS Consultant on call and the AMS Team. It is the responsibility of the prescriber to notify the pharmacy if ID approval is granted.
This consultation must be documented in the patient’s medical notes and any approvals also documented, before further stock will be supplied from the pharmacy.
A unique approval number will be given to the prescriber and be annotated as described below.
Document the antimicrobial plan on the medication chart as per this example:
The National Inpatient Medication Chart should be annotated with the following information:
- The Indication for Antimicrobial Therapy
- The Intended Duration or Review Date for Antimicrobial Therapy
- The words “ID approved” and the unique ID Approval number provided by the Approving ID Physician or Microbiologist.
The chart should be Numbered with the Days of Therapy to assist with review.
Outpatient prescription
The Outpatient prescription should be annotated with the following information:
- The Indication for Antimicrobial Therapy
- The Intended Duration or Review Date for Antimicrobial Therapy
- The PBS restriction/ authority number (If required)
- The unique ID Approval number provided by the Approving ID Physician or Microbiologist.