Attachment 4

Patient Group Direction For Supply of Azithromycin for Treatment of Chlamydia by Pharmacists

November 2007

Patient Group Direction For Supply of Azithromycin for Treatment of Chlamydia by Pharmacists

Rationale

To enable a pharmacist working in City and Hackney, who has received specific training and has been assessed as competent, to supply azithromycin for treatment of chlamydia in accordance with the following patient group direction (PGD).

Professionals to whom these directions may apply

Qualifications Required / Pharmacist (registered with RPSGB or PSNI)
Additional Requirements / Access to:
  • British National Formulary, latest edition
  • City and Hackney Teaching PCT/Homerton University Hospital NHS Trust Joint Formulary, latest edition
  • City and Hackney Teaching PCT medicines policies
  • British Association for Sexual Health and HIV Guideline for the Management of Genital Tract Infection with Chlamydia trachomatis

Continuing Training Requirements / It is the responsibility of the individual pharmacist to ensure that they are competent in all aspects of supply of drugs under PGD and is updated on current medicines policies.

References

  • Department of Health (1998): Review of Prescribing, Supply and Administration of Medicines. A report on the Supply and the Administration of Medicines under Group Protocol
  • British Association for Sexual Health and HIV (2006): UK National Guideline for the Management of Genital Tract Infection with Chlamydia trachomatis

ALL PATIENT GROUP DIRECTIONS WILL BE SUBJECT TO REGULAR REVIEW IN LINE WITH CURRENT CLINICAL PRACTICE

Patient Group Direction for the supply/administration of / AZITHROMYCIN
to /
YOUNG PEOPLE16 TO 24 YEARS OF AGE AND OVER 45KG IN WEIGHT
1. Clinical Condition
Define situation/condition / Proven Chlamydial Infection (i.e. positive screen for uncomplicated genital Chlamydia trachomatis infection using Nucleic Acid Amplification Technique)
Criteria for inclusion / Young person (16 to 24years of age and over 45Kg in weight) with a laboratory confirmed diagnosis (using Nucleic Acid Amplification Technique) of uncomplicated Chlamydia trachomatis infection, who have been referred to the pharmacy by the City and Hackney PCT Chlamydia Screening Officer
Criteria for exclusion /
  • Any patient under the age of 16 years;
  • History of allergic reaction to Azithromycin, another macrolide, or any ingredients in the product;
  • In pregnancy/breast feeding – manufacturer recommends use only if no alternative is available. Not enough information available;
  • Any patient with a history of hepatic impairment;
  • Taking any drug on the current BNF drug interaction list;
  • Patients who do not consent to treatment within this PGD

Action if excluded / Refer to a GP or other doctor as soon as possible, and within 24 hours if clinically urgent
Action if patient declines /
  • Advise patient of alternative sources of treatment;
  • Refer to GP if appropriate;
  • Provide appropriate advice;
  • Document advice given

2. Description of treatment
Name of Medicine / Azithromycin
Formulation / 250mg Capsule
POM/P/GSL / POM
Dose/s / Azithromycin 1 gram (4 x 250mg capsules)
Route/Method / Oral
Frequency / Observed stat dose 1 hour before or 2 hours after food or on empty stomach
Total dose number / One
Adviceand Follow up /
  • Advise patient of potential side effects of nausea, vomiting, diarrhoea;
  • Advise patients to avoid indigestion remedies within 2 hours of taking Azithromycin as these could affect absorption;
  • Advice regarding antibiotics and hormonal contraception
  • Return to pharmacy if vomiting occurs within 3 hours;
  • Give appropriate sexual health promotion advice i.e. offer condoms and leaflets on Chlamydia and other STIs;
Discuss with patient and provide clear written information on:
  • What C.trachomatis is and how it is transmitted:
  • It is primarily sexually transmitted
  • If asymptomatic there is evidence that it could have persisted for months or years
  • The diagnosis of C.trachomatis, particularly:
  • It is often asymptomatic in both men and women
  • Whilst tests are accurate, no test is absolutely so
  • The complications of untreated C.trachomatis
  • The importance of their sexual partner(s) being evaluated and treated;
  • Advised to abstain from sexual intercourse until they and their partner(s) have completed therapy (and waited 7 days if treated with azithromycin);
  • Advice on safer sexual practices, including advice on correct, consistent condom use

Records /
  • Patient’s name or initials, date of birth and GP details, if they are willing to share these details. The first part of the post-code and the number from the 2nd part should be recorded for analytical purposes;
  • Diagnosis;
  • Dose and form administered;
  • Advice given to patient;
  • Manufacturer of product, batch, and expiry date;
  • Member of staff who administered the medication;
  • Medication box should have patient number/name and date of issue written on label prior to supply;
  • All adverse effects to be reported in the patient’s notes and to the PCT

Page 1 of 5

City & Hackney TPCT PGD for azithromycin

Version printed: November 2007