5.1.12. Quinolones
Prescribing Notes:
- Due to the risk of severe, disabling and potentially permanent adverse events, new restrictions apply to the prescribing of fluoroquinolones. Please see new MHRA advice (January 2024) and NHSGGC statement (April 2024) for more details.
- Ciprofloxacin should be prescribed by mouth in preference to IV where possible, as oral dosing gives similar concentrations to IV administration. The exception is when the oral route is compromised (e.g. nil by mouth, reduced absorption, unconsciousness, vomiting or mechanical swallowing disorder).
- The NHSGGC Infection Management guidelines can provide advice on when use is appropriate.
- Please note: the IV FORM of ciprofloxacin is a PROTECTED ANTIBIOTIC (see policy here) and relevant paperwork should be completed.
Restrictions:
Restricted to use on the advice of a consultant microbiologist or consultant infectious disease physician for patients with acute bacterial skin and skin structure infections (ABSSSI) who have suspected or confirmed polymicrobial infection following treatment failure or when standard antibacterial therapies are not suitable.
Please note: this is a PROTECTED ANTIBIOTIC (see policy here) and relevant paper work should be completed.
Prescribing Notes:
Due to the risk of severe, disabling and potentially permanent adverse events, new restrictions apply to the prescribing of fluoroquinolones.
Please see new MHRA advice (January 2024) and NHSGGC statement (March 2024) for more details.
Restrictions:
Restricted to specialist initiation.
- oral tablets and infusion: restricted to second line use by hospital specialists for penicillin allergic patients with community or hospital acquired pneumonia or for cystic fibrosis patients intolerant of ciprofloxacin where a quinolone is required.
- nebules (Quinsair®): restricted to specialist initiation and use as third-line treatment option after colistimethate sodium (first line) and tobramycin (second line).
Prescribing Notes:
Due to the risk of severe, disabling and potentially permanent adverse events, new restrictions apply to the prescribing of fluoroquinolones.
Please see new MHRA advice (January 2024) and NHSGGC statement (March 2024) for more details.
Restrictions:
Restricted to specialist initiation. Treatment of community acquired pneumonia (CAP) is restricted to use on the advice of microbiologists or specialists in infectious diseases. Restricted to second line use by hospital specialists for cystic fibrosis patients intolerant of ciprofloxacin where a quinolone is required.
Prescribing Notes:
Due to the risk of severe, disabling and potentially permanent adverse events, new restrictions apply to the prescribing of fluoroquinolones.
Please see new MHRA advice (January 2024) and NHSGGC statement (March 2024) for more details.
Please note: Oral and IV forms are a PROTECTED ANTIBIOTIC (see policy here) and relevant paperwork should be completed.
Restrictions:
Restricted to use in the treatment of pelvic inflammatory disease and epididymitis.
Prescribing Notes:
Due to the risk of severe, disabling and potentially permanent adverse events, new restrictions apply to the prescribing of fluoroquinolones.
Please see new MHRA advice (January 2024) and NHSGGC statement (March 2024) for more details.