7.0 - Antimicrobial Restriction Classification

Green Light: Unrestricted (Generally Available Without Prescribing Restrictions)

Aciclovir Inj / PO Benzathine Penicillin G Inj Cloxacillin Inj / PO Erythromycin PO
Albendazole PO Benzylpenicillin G Inj  Co-amoxiclav Inj / PO Metronidazole Inj / PO
Amoxicillin PO Ampicillin / Sulbactam Inj / PO  Trimethoprim / Sulfamethoxazole
Inj / PO 
Phenoxymethylpenicillin PO
Ampicillin Inj / PO Cefuroxime Inj / PO Dapsone PO  
Cefazolin Inj Cephalexin PO Doxycyline PO  

Amber Light: Restricted to ID Unless For Specific Indications Outlined Below

Amikacin Inj Bronchiectasis, Mycobacterium avium complex, use as nebulizer for Cystic Fibrosis / Pseudomonas infections in paediatrics
Antiretrovirals Inj / PO HIV
Artesunate Inj Severe / complicated malaria
Arthemether / Lumafantrine (Riamet) PO
Azithromycin Inj / PO Community Acquired Pneumonia, Pelvic Inflammatory Disease, STD, Non-Tuberculous Mycobacteria
Cefepime Inj Empirical Treatment for
Hospital Acquired Infection, severe sepsis, Febrile Neutropenia
Directed Treatment for
Pseudomonas aeruginosa infection
Cefoperazone Inj Intra-abdominal infections
Cefotaxime Inj For paediatrics only
Ceftazidime Inj Confirmed pseudomonas infections, Burkholderia pseudomallei infections, Bukholderia cepacia infections, intraperitoneal for peritonitis in PD patients
Ceftriaxone Inj Central nervous system infections, orbital cellulitus, moderate severity CURB 65 score = 1-2, Community Acquired Aspiration Pneumonia or lung abscess, pyelonephritis, prostatitis, gonorrhea, pelvic inflammatory disease, chancroid, leptospirosis, acute epiglottitis, acute mastoiditis, cholecystitis, cholangitis, liver abscess, peritonitis
Ciprofloxacin Inj / PO Neisseria meningitides prophylaxis, alternative treatment for Pseudomonas aeruginosa when other options are not available, directed treatment for Salmonella Enteritidis
Clindamycin Inj / PO Necrotizing fasciitis, Pneumonitis Jiroveci Pneumonia, alternative for allergy to penicillin
Ethambutol PO Anti-mycobacterium
Isoniazide PO
Pyrazinamide PO
Fluconazole Inj / PO Fungal Infection
Candida albicans infection sensitive to fluconazole
Ganciclovir Inj  Cytomegalovirus
Gentamicin Inj  Combination therapy for bronchiectasis, combination therapy in infective endocarditis, combination therapy in suspected pseudomonas infection, use as nebulizer for cystic fibrosis / pseudomonas infection in Paediatrics
Imipenem Inj Empirical Treatment
Present with risk of Extended Spectrum Beta Lactam (ESBL) producing organisms, severe sepsis, febrile neutropenia
Directed Treatment
ESBL producing organism, Citrobacter sp, Enterobacter sp, Serratia sp
Meropenem Inj Use for the following condition when Imipenem can't be used:
Empirical Treatment
Present with risk of Extended Spectrum Beta Lactam (ESBL) producing organisms, severe sepsis, febrile neutropenia
Directed Treatment
ESBL producing organism, Citrobacter sp, Enterobacter sp, Serratia sp
Mupirocin LA Decolonization for Staphylococcus aureus, hemodialysis catheter related infection, non-bullous and bullous impetigo
Nitrofurantoin PO Uncomplicated UTI treatment and prophylaxis
Nystatin PO / PV Oral candidiasis, vaginal candidiasis
Oseltamovir PO If influenza is suspected
Pentamidine Inj Pneumonitis Jiroveci Pneumonia (PCP) treatment and prophylaxis
Piperacillin / Tazobactam Inj Empirical Treatment for
Hospital acquired infection, severe sepsis, febrile neutropenia
Directed Treatment for
Pseudomonas aeruginosa infection
Primaquine PO Check G6PD status before use. For combination therapy with Clindamycin for Pneumocystis Jirovecii Penumonia (PCP), combination with Riamet® for malaria treatment
Pyrimethamine PO Toxoplasma gondii encephalitis treatment and secondary prophylaxis
Pyrimethamine / Sulfadoxine PO
Quinine PO Uncomplicated malaria treatment
Rifampicin PO Anti-mycobacterium
Gram positive organism in combination with Sodium Fusidate or Cloxacillin
Sodium Fusidate PO MRSA infection in combination with Rifampicin
Streptomycin Inj Mycobacterium Avium Complex (MAC) treatment, second line anti-TB treatment
Vancomycin Inj Empirical Treatment for
Line related infection, endocarditis where MRSA or resistance gram positive organism is suspected.
Directed Treatment for
Susceptible organism where other options are not available, i.e. MRSA, Ampicillin resistant Enterococcus

Red Light: Must Be Prescribed or Approved by ID or Specific Specialist

Ertapenem Inj Infectious Disease specialist
Linezolid Inj Infectious Disease specialist
Rifabutin PO Infectious Disease specialist
Levofloxacin PO Infectious Disease specialist and Respiratory specialist
Moxifloxacin PO Infectious Disease specialist and Respiratory specialist
Colistin Inj Infectious Disease specialist, Respiratory specialist, Anaesthesiologist
Ganciclovir Inj Infectious Disease specialist, Haemotologist, Opthalmologist, Nephrologist
Valganciclovir PO Infectious Disease specialist, Haemotologist, Opthalmologist, Nephrologist
Voriconazole Inj / PO Infectious Disease specialist and Haemotologist
Amphotericin B Inj Infectious Disease specialist and Haemotologist
Amphotericin B Liposomal Inj Infectious Disease specialist and Haemotologist
Anidulafungin Inj Infectious Disease specialist and Haemotologist
Caspofungin Inj Infectious Disease specialist and Haemotologist
Itraconazole PO Syrup Infectious Disease specialist and Haemotologist
Itraconazole PO Capsule Infectious Disease specialist, Haemotologist and Dermatologist
Minocycline PO Infectious Disease specialist and Dermatologist
Clarithromycin PO Infectious Disease specialist and Gastroenterologist
Norfloxacin PO Infectious Disease specialist and Gastroenterologist