• Haematology/Oncology


• all other indications require IMPS approval

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• Treatment of adults and children with Ancylostoma caninum (Eosinophilic enterocolitis), Ancylostoma duodenale/Necator americanus (Hookworm), Ascaris lumbricoides (Roundworm), Trichuris trichiuria (Whipworm) or Enterobius vermicularis (Pinworm).


• For prophylaxis against Snail and Slug Ingestion (Angiostrongylus cantonensis infection/ rat lung worm)


• IMPS approval is required for all other indications including for treatment of Echinococcus granulosus (Hydatids) and alternative treatment for children with Strongyloides stercoralis.

• Triple therapy pre-approved for 7 days for proven H.pylori eradication under care of a Gastroenterologist according to the Australian Therapeutic guidelines (Antibiotics).

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• For severe community acquired pneumonia >5yoa (According to PICU Empirical antibiotic guidelines),


• For treatment of severe acute Bordetella pertussis infection where PO medications contraindicated or not tolerated (according to PICU Empirical antibiotic guidelines and CHQ Antibiocard)


• All other indications require IMPS Approval

• Department of Ophthalmology


• All other indications require IMPS approval.

Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• According to CHQ Guideline: Empirical antimicrobial therapy for children with Non-Cystic Fibrosis Bronchiectasis for up to 14 days.


• ID Approval required after 72 hours therapy for:


• Empiric therapy for suspected or proven meningitis or community acquired sepsis (PICU and Non PICU) or skeletal/soft tissue infections (if <5yo and not Hib immune) or cholangitis (according to CHQ Antibiocard  and CHQ PICU Empirical antibiotic guidelines)

or

• PICU: Severe empyema and community acquired pneumonia (according to CHQ PICU Empirical antibiotic guidelines ) for up to 72 hours (ID approval required after 72 hours)


• For Nosocomial/ ventilator associated pneumonia for patients who have been in PICU for less than 5 days, for up to 72 hours (ID approval required after 72hours) according to CHQ PICU Empirical antibiotic guidelines

or

• ID Approval required after 24 hours therapy for:


• Empirical therapy for suspected Tracheitis, epiglottitis and retropharyngeal abscess (according to CHQ Antibiocard)

All other indications require IMPS approval

Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• For use in Cystic fibrosis patients for inpatient and HITH management (intermittent dosing) according to CHQ-GDL-01073 Empirical antimicrobial therapy for children with Cystic Fibrosis  for up to 14 days


• For use in Non CF bronchiectasis patients for inpatient management (intermittent dosing) according to CHQ-GDL-01072 Non-Cystic Fibrosis Bronchiectasis - Antimicrobial Therapy for Children  for up to 14 days


• For use in accordance with the CHQ Febrile Neutropenia protocol (PDF) for up to 72hours (ID approval required after 72 hours), in patients with delayed type hypersensitivity to piperacillin/tazobactam.


• For Nosocomial sepsis (PICU) for up to 72 hours (ID approval required after 72hours) according to CHQ PICU Empirical antibiotic guidelines


• For Nosocomial/ ventilator associated pneumonia for patients who have been in PICU for more than 5 days, for up to 72 hours (ID approval required after 72hours) according to CHQ PICU Empirical antibiotic guidelines


• All other indications require IMPS approval

Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• According to CHQ Guideline: Empirical antimicrobial therapy for children with Non-Cystic Fibrosis Bronchiectasis for up to 14days.


• ID Approval required after 72 hours therapy for:


• Empiric therapy for suspected or proven meningitis or community acquired sepsis (PICU and Non PICU) or skeletal/soft tissue infections (if <5yo and not Hib immune) or cholangitis (according to CHQ Antibiocard and CHQ PICU Empirical antibiotic guidelines)

or

• PICU: Severe empyema and community acquired pneumonia (according to CHQ PICU Empirical antibiotic guidelines) for up to 72 hours (ID approval required after 72 hours)

• For Nosocomial/ ventilator associated pneumonia for patients who have been in PICU for less than 5 days, for up to 72 hours (ID approval required after 72hours) according to CHQ PICU Empirical antibiotic guidelines

•  


• OR


• ID Approval required after 24 hours therapy for:


• Empirical therapy for suspected Tracheitis, epiglottitis and retropharyngeal abscess (according to CHQ Antibiocard)

All other indications require IMPS approval

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• For use in Non CF bronchiectasis patients according to criteria specified in CHQ-GDL-01072 Non-Cystic Fibrosis Bronchiectasis - Antimicrobial Therapy for Children


• All other indications require IMPS approval

• Department of Ophthalmology


• All other indications require IMPS approval.

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• for Cystic fibrosis patients according to CHQ Respiratory Antibiocard

or

• for Chemoprophylaxis of meningococcal contacts on advice from Infectious diseases consultant/ Public health medical officer (according to CHQ Antibiocard)


• all other indications require IMPS approval

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

Approval required after 48 hours therapy for:

• Empiric therapy for suspected or proven impetigo or cellulitis or cervical lymphadenitis (outpatient management) in patients at risk of nMRSA in accordance with CHQ Antibiocard.


• All other indications require IMPS Approval

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

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• For empiric therapy according to CHQ guideline: Management of Water-related Wound Infections in Children, in an established wound infection where wound was sustained during exposure to water (treatment – no organism identified) in children > 8 years of age. IMPS review and approval required within 24hours.


• CHQ IMPS Approval and discussion required for children <8 years of age and a diagnosis of Ricksettsial disease including Q Fever.


• For treatment of severe acne in children aged 8 years or older, under care of Dermatologist. Pre-approved duration: 3 months. IMPS approval required after 3 months.


• All other indications require IMPS Approval

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• Haematology/Oncology team for use in the paediatric population (up to 18 years of age) for:


• Prophylaxis of viral infection for 12 months following allogeneic bone marrow transplant;


• Prophylaxis of viral infection for 3 months following autologous bone marrow transplant.


• Treatment of immunocompetent patients with herpes zoster in whom the duration of rash is less than 72 hours.


• Herpes zoster in immunocompromised patients.


• Ophthalmic herpes zoster.

All other indications require IMPS Approval

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:

• Empiric therapy for suspected sepsis (neonates), peritonitis, necrotising enterocolitis, NEC or uncomplicated and complicated appendicitis, pyelonephritis (or UTI in < 3 month old) and endocarditis according to CHQ Antibiocard


• For severe abdominal infection (including peritonitis and necrotising enterocolitis), nosocomial sepsis (including central venous line sepsis), surgical wound infection, urinary tract infection for critically ill patients according to CHQ PICU Empirical antibiotic guidelines


• For Use in accordance with CHQ Paediatric Surgical Antibiotic Prophylaxis guideline


• all other indications require IMPS approval

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:

• Urinary tract infections

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

Restricted to prescribing by the following authorised specialists:

1. Rheumatologists


2. Immunologists


3. Dermatologists specifically treating patients with cutaneous lupus


4. Nephrologists specifically treating patients with SLE


5. Infectious diseases specialists for treatment of patients with Q fever


6. Prescribers providing ongoing therapy for patients with SLE or severe RA

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

• Do not use hydroxychloroquine for the treatment of COVID-19.


• This recommendation applies to adults, children and adolescents, pregnant and breastfeeding women, older people living with frailty and those receiving palliative care.


• Use of hydroxychloroquine may still be considered in the context of randomised trials with appropriate ethical approval, such as combination therapies that include hydroxychloroquine.

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:

• For use in patients with risk factors for nMRSA, as empiric antibiotic therapy (in combination with appropriate agents) for severe cellulitis, community acquired sepsis, empyema, toxic shock syndrome and bone/joint infection for critically ill patients according to CHQ Antibiocard and PICU Empirical antibiotic guidelines


• For use in accordance with CHQ Surgical Antibiotic Prophylaxis guidelines, in patients who have an immediate type hypersensitivity to penicillins/ cephalosporins


• all other indications require IMPS approval

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• For use by Dermatologist in the treatment of severe acne


• all other indications require IMPS approval

• For use in according to CHQ MRSA eradication procedure (QH staff only).


• all other indications require IMPS approval

• On advice from Ophthalmology team


• All other indications require IMPS approval

Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• For use in Cystic fibrosis patients for inpatient and HITH management according to CHQ-GDL-01073 Empirical antimicrobial therapy for children with Cystic Fibrosis for up to 14 days


• For use in Non CF bronchiectasis patients for inpatient management (intermittent dosing) according to CHQ-GDL-01072 Non-Cystic Fibrosis Bronchiectasis - Antimicrobial Therapy for Children for up to 14 days

or

• For empiric treatment of complicated appendicitis for up to 4 days according to CHQ Antibiocard. ID review and approval required after 24 hours. ID review and approval required after 4 days.


• For open compound fractures with severe tissue damage or clinical evidence of skin/soft tissue infection (up to 24hours) according to CHQ Antibiocard (ID approval required after 24 hours)


• For use in accordance with the CHQ Febrile Neutropenia protocol (PDF) for up to 72 hours (ID approval required after 72 hours)

or

• Empiric therapy for Suspected Central Venous Access Device (CVAD) Infection (for up to 72hrs) according to CHQ guideline: Fever in a Child with Central Venous Access Device (ID approval required after 72 hours)

or

• For use as per CHQ Liver transplant protocol (PDF)(QH staff only) (up to 24 hours) (ID approval required after 24 hours)


• or as a single dose per CHQ Renal transplant protocol (PDF)(QH staff only)


• or for Percutaneous transhepatic cholangiogram (with or without stent placement) per CHQ Surgical antibiotic prophylaxis guideline

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• For Chemoprophylaxis of meningococcal contacts on advice from Infectious diseases consultant.


• All other indications (including off label use) require IMPS approval

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• For use on advice from Dermatologist


• All other indications require IMPS approval

Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

Intravenous:

• For use in Cystic fibrosis patients for inpatient and HITH management according to CHQ-GDL-01073 Empirical antimicrobial therapy for children with Cystic Fibrosis  for up to 14 days


• For use in Non CF bronchiectasis patients for inpatient management according to CHQ-GDL-01072 Non-Cystic Fibrosis Bronchiectasis - Antimicrobial Therapy for Children  for up to 14 days


• All other indications require IMPS Approval

Nebulised:

• For use in Cystic fibrosis patients according criteria specified in CHQ-GDL-01073 Empirical antimicrobial therapy for children with Cystic Fibrosis


• Queensland Children's Hospital: For use in Non CF bronchiectasis patients according to criteria specified in CHQ-GDL-01072 Non-Cystic Fibrosis Bronchiectasis - Antimicrobial Therapy for Children (For all other sites - ID approval as per local practices)
  
  

Pre-approved for first dose challenge, SPT or IDT by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

Approval required after 48hours for:

• use as initial treatment of suspected or proven PCP OR for PCP prophylaxis if unable to tolerate oral therapy. IMPS review and approval required within 48hours.


• All other indications require IMPS approval

Pre-approved for first dose challenge by Paediatric Immunologist/Allergist. Ongoing use/ desensitisation – ID approval required.

• For use as CMV prophylaxis in accordance with the CHQ Liver transplant protocol (QH staff only) and CHQ Renal transplant protocol (QH staff only)


• All other indications require IMPS approval

• Department of Ophthalmology


• All other indications require IMPS approval

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:

• Community acquired pneumonia (not tolerating oral therapy)


• Cellulitis


• Lymphadenitis


• Pre-septal/peri-orbital cellulitis


• Urinary tract infections

see QCH Antimicrobial Formulary.

Written confirmation of Infectious Diseases approval needs to accompany (CHQatHome) referral form.