• Haematology/Oncology


• all other indications require IMPS approval

• 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).


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

• Haematology/ Oncology (according to CHQ Febrile neutropenia protocol – febrile neutropenic >96hours – ID consultation required within 24hours from commencing)

• in accordance with CHQ Post liver transplant protocol (Use in high risk patients -with cholestasis OR a 2nd transplant OR if active fungal infection)


• All other indications including prophylaxis require IMPS approval

• Cystic fibrosis specialists treating cystic fibrosis patients as prophylaxis of exacerbations of chronic Pseudomonas aeruginosa infection,


• For use according to CHQ Guideline for Azithromycin prophylaxis in children with non cystic fibrosis (non-CF) bronchiectasis or chronic suppurative lung disease (CSLD) for up to 24 months of therapy (see CHQ Guideline for criteria of cessation and re-initiation of therapy- if patient does not meet criteria- ID approval required).


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


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


• For STD prophylaxis per Child Advocacy service protocol


• All other indications including prophylaxis require IMPS Approval

• 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

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


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

• 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

• Department of Ophthalmology


• all other indications require IMPS approval.

• 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

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

For use by haematology/oncology as alternative to trimethoprim/sulfamethoxazole as PCP prophylaxis

• 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.


• All other indications require IMPS Approval

• 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

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

• For use in rheumatological /interstitial lung disease/ immunological conditions.


• All other indications require IMPS approval

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

• 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

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

or

• 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 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(QH staff only) (up to 24 hours) (ID approval required after 24 hours)


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


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

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


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

• For use on advice from Dermatologist


• All other indications require IMPS approval

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


• All other indications require IMPS Approval

Oral

• Department of Ophthalmology for treatment of severe herpes zoster ophthalmicus

On the advice of Consultant Specialist Staff for:

• a) Treatment of herpes simplex virus infections in immunocompromised paediatric patients (up to 18 years of age);


• or


• b) Treatment of herpes zoster in immunocompromised patients;


• or


• c) 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.


• All other indications require IMPS approval


• Microbiological confirmation of diagnosis (viral culture, antigen detection or nucleic acid amplification by PCR) is required but need Not delay commencing treatment of the initial episode. Once microbiological diagnosis confirmed, subsequent recurrences may be treated on clinical grounds.

For use in accordance with the:

• CHQ Febrile Neutropenia protocol


• CHQ Repair of fractured tunnelled cuffed central venous catheter guideline ( 1 dose),


• CHQ Surgical Antibiotic Prophylaxis protocol and CHQ Cardiac surgical antibiotic prophylaxis protocol

Approval required after 72 hours therapy for:

• Empiric therapy for suspected or proven meningitis (gram positive cocci in CSF), endocarditis, community acquired/nosocomial sepsis (PICU) in accordance with CHQ Antibiocard or CHQ PICU Empirical antibiotic guideline


• All other indications required IMPS team approval.

• For use in accordance with Oncology/ Haematology antifungal prophylaxis and treatment guideline (for treatment- IMPS approval required)


• All other indications require IMPS approval

• For use in accordance with CHQ Clostridium difficile infection CHQ Clostridium difficile infection management guideline (QH staff only) with IMPS approval only