North of Tyne APC Update October 2015

Recent decisions – Latest Decisions | North Of Tyne Area Prescribing Committee

Methenamine hippurate has been requested as a second line agent for the prophylaxis of UTIs in patients who have failed long term prophylaxis with antibiotics, have contraindications to antibiotics, and who have breakthrough infections with resistant organisms. This is on the grounds that as a non-antibiotic urinary antibacterial it will not contribute to antibiotic resistance. It was recognised that this product has only limited clinical value but that the current antimicrobial resistance crisis has given greater weight to its potential role.

It was acknowledged that there is currently no evidence, either way, to support the long term use of methenamine hippurate for UTI prophylaxis in patients without renal tract abnormalities. The committee noted additional correspondence between urology consultants and Mr Lowery in relation to the required level of microbiology advice and requesting an amendment to the indications to include those patients who do not wish to take prophylactic antibiotics on account of the possibility of antimicrobial resistance. This communication was noted but the original FSC recommendation was supported.

Decision: The request for methenamine hippurate after an appropriate sequence of antibiotics, and following the advice of microbiology, was approved.

Longtec®

Strong modified release opiates should be prescribed by brand name.

Longtec® has now been approved as the preferred formulary option on the basis of cost. It was noted that this is identical to the originator brand in terms of release characteristics.

The use of Shortec® capsules was not currently supported. Where a shorter acting oxycodone preparation is required, palliative care clinicians have requested that this should continue to be provided in a liquid form.

Guidelines

Available at  Guidelines and Statements | North Of Tyne Area Prescribing Committee

• North Tyneside and Northumberland COPD Guideline – approved
• Erectile dysfunction – updated
• Oral anticoagulant comparison document – updated
• Type 2 diabetes – approved

Information leaflets

Available at  Information Leaflets | North Of Tyne Area Prescribing Committee

• Antipsychotics – updated
• Nebulised Gentamicin – updated