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Home > Formulary : Adult > Chapters > 5. Infections >

BNSSG Adult Joint Formulary

5.3 Fungal infection

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Last edited: 30-07-2024

First line drugs Second line drugs Specialist drugs Secondary care drugs

 

Antifungals

Recommended:

Terbinafine (oral) (TLS Green)

Alternatives:

Griseofulvin (oral) (TLS Blue)

 

Echinocandin antifungals

Recommended:

Micafungin (parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

Caspofungin (parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

 Anidulafungin (parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

 Rezafungin (parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines (NHSE Commissioned)

 

Fluorinated Pyrimidine Antifungals

Flucytosine (oral & parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

 

Polyene Antifungals

Recommended:

Liposomal amphotericin (parenteral) (TLS Red)

  • Restricted, see local guidelines.
  • UHB & NBT - liposomal amphotericin now only stocked. Prescriptions should state the patient's weight and dose in mg/kg
  • The National Patient Safety Agency has advised all healthcare staff involved in the use of intravenous amphotericin of the potentially lethal results if non-lipid and lipid formulations of the drug are confused.
  • Caution: double check

 

Triazole Antifungals

Recommended:

Fluconazole (oral) (TLS Green)

Alternatives:

Itraconazole (oral) (TLS Blue)

  • Restricted, see local guidelines

Fluconazole (parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

Voriconazole (oral & parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

Posaconazole (oral) (TLS Red)

  • Secondary care restricted, see local guidelines

Isavuconazole (oral & parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

Refer to Chapter 12 for oropharyngeal antifungal drugs

 

5.3.1 Pneumocystis pneumonia

Recommended: (TLS Green)

Co-trimoxazole (oral)

Trimethoprim (oral)

  • Secondary care restricted, see local guidelines

Alternatives:

Co-trimoxazole (parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

Atovaquone (oral) (TLS Red)

  • Secondary care restricted, see local guidelines

Clindamycin (oral & parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

Dapsone (oral) (TLS Red)

  • Secondary care restricted, see local guidelines

Pentamidine (parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

Pentamidine (nebulised) (TLS Red)

  • Secondary care restricted, see local guidelines

Primaquine (oral) (unlicensed) (TLS Red)

  • Secondary care restricted, see local guidelines

 

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