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Antibiotic Prescribing - Conditions and Treatments
Eye and Ear
Upper Respiratory
Acute Sinusitis (Adults)
Acute Cough in Children
Otitis Media in Children
Pharyngitis Sore Throat Tonsillitis
Lower Respiratory
Pneumonia and Aspiration Pneumonia in Nursing Homes/Residential Care Facilities
Acute Cough, Bronchitis (Adults)
Bronchiolitis in Children
Acute Cough in Children
Acute Exacerbation of COPD
Community Acquired Pneumonia (Adults)
Community Acquired Pneumonia in Children
COVID -19 Acute Respiratory Infection (Adults)
Azithromycin Prophylaxis in Adults with Respiratory Disease
Influenza
Meningitis
Pregnancy and Postpartum Infections
Prescribing Antimicrobials in Pregnancy and Lactation
Mastitis
Endometritis
Perineal wound infection
C-section wound infection
Nipple and breast thrush
UTI in Pregnancy
Asymptomatic Bacteriuria in Pregnancy
Influenza in Pregnancy
Urinary
Position Statements Dipstick Urinalysis for UTIs in Adults
Deprescribing UTI prophylaxis
Acute Pyelonephritis
Adult Male UTI
Adult Female UTI
Urinary Tract Infections (UTI) in Residential Care Facilities / Nursing Homes
Catheter-Associated Urinary Tract Infections (CA-UTI)
Recurrent UTI in Adult, Non-Pregnant Females
UTI in Children
UTI in Pregnancy
Gastro
Infectious Diarrhoea
Threadworms
Traveller's Diarrhoea
Clostridioides difficile
Helicobacter pylori
Shigellosis
Genital
Approach to an STI consultation in Primary Care
Acute Prostatitis
Acute Epididymo-orchitis
Bacterial Vaginosis
Chlamydia trachomatis
Gonorrhoea
Pelvic Inflammatory Disease
Trichomoniasis
Candida, Genital Thrush
Anogenital Warts
Syphilis
Genital Herpes
Shigellosis
Skin/Soft Tissue
Acne Vulgaris - Antibiotic Prescribing
Animal and Human Bite - Antibiotic Prescribing
Candida - Skin and Oral
Cellulitis
Chickenpox
Conjunctivitis - Antibiotic Prescribing
Dermatophyte Infection Fingernail or Toenail
Dermatophyte Skin Infections
Eczema
Headlice
Hidradenitis Suppurativa - Antibiotic Prescribing
Impetigo
Lyme Disease
Pityriasis versicolor / Tinea versicolor
Rosacea
Scabies
Shingles
Staphylococcal Nasal Carriage
Tinea capitis (scalp ringworm)
Oral/Dental
Dry Socket
Dental prescription guidelines
Angular Cheilitis
Acute Sinusitis
Endocarditis Prophylaxis
Pericoronitis
Dental Guidelines
Periodontal Abscess
Acute Dento-Alveolar Infection
Necrotising Gingivitis
Fungal Infections
Safe Prescribing
Communications from AMRIC
Infection Prevention and Control
Drug Interactions
Hospital Related Guidelines
About us
Prescribing for Children
Antibiotic Prescribing - Conditions and Treatments
Safe Prescribing
Drug Interactions
Hospital Related Guidelines
About us
Antibiotic Prescribing
Antibiotic Prescribing - Conditions and Treatments
Genital
Genital Herpes
Genital Herpes
Comments from Expert Advisory Committee
Genital Herpes can be caused by either herpes simplex virus (HSV) 1 or 2
Following direct inoculation to the genital area individuals can experience a prodromal viral illness, genital itch, vesicles, painful ulceration with painful regional lymphadenopathy within seven days of infection. The genital ulceration will spontaneously clear and thereafter the virus remains dormant in local sensory ganglia and can reactivate periodically resulting in symptomatic lesions or asymptomatic, but infectious, viral shedding. The likelihood of recurrence is greater with HSV-2 than HSV-1 and the likelihood of recurrences and asymptomatic viral shedding reduces over time.
The diagnosis can be made clinically but should be confirmed with a HSV NAAT swab of the lesions to determine if HSV-1 or HSV-2.
HSV NAAT swabs are available to order from the NVRL
Treatment should be started on the basis of clinical impression.
Topical antiviral medication is not as effective as oral antiviral medication.
Simple oral analgesia and local anaesthetic cream (e.g. EMLA cream)
Advise micturition into bath water to relieve dysuria
Hospitalisation may be required for urinary retention, meningism or severe constitutional symptoms.
Patients diagnosed with HSV-2 should be advised to avoid sexual contact when they have symptoms of genital herpes unless it is known that their partner has already been exposed to HSV-2. Some patients experience great difficulty adjusting to a genital herpes diagnosis. The
Herpes Viruses Association in the UK
is an excellent resource for additional patient support.
Individuals diagnosed with genital herpes should be offered testing for other STIs including HIV, Hepatitis B, syphilis, chlamydia and gonorrhoea. It is reasonable to do a vulvovaginal swab for Chlamydia/Gonorrhoea at initial presentation if the patient can tolerate same. A speculum exam at time of acute infection is rarely indicated and should be deferred.
Hepatitis C testing
should be considered part of routine sexual health screening in the following circumstances: MSM, People living with HIV; Commercial sex workers; People who inject drugs (PWID). Partners of the above should also be considered for HCV testing.
Pregnant patients with a history of genital herpes should inform their obstetrician of this history and referral to a GUM clinic should be considered, particularly if the patient is experiencing frequent recurrences.
Patients presenting with genital herpes for the first time in pregnancy should have the diagnosis confirmed, treatment started and be referred to a GUM clinic.
Patients presenting with frequent recurrences (>/= one per month) should be offered suppressive therapy and may be best managed at a GUM clinic.
Genital Herpes Simplex is a notifiable disease. The complete list of notifiable diseases and information on the notification process is available at HPSC
Treatment
Patient information
Patient information on STIs and genital conditions is available at the HSE Sexual Health and Crisis Pregnancy website
Genital Herpes PIL
Herpes Viruses Association in UK
Safe Prescribing
(visit the safe prescribing page)
Doses are oral and for adults unless otherwise stated
Renal impairment dosing table
Safety in Pregnancy and Lactation
Drug interactions table
. Extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.
Visit the
Health Products Regulatory Authority (HPRA) website
for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC).
Reviewed June 2021
Antibiotic Prescribing - Conditions and Treatments
Eye and Ear
Upper Respiratory
Lower Respiratory
Influenza
Meningitis
Pregnancy and Postpartum Infections
Urinary
Gastro
Genital
Approach to an STI consultation in Primary Care
Acute Prostatitis
Acute Epididymo-orchitis
Bacterial Vaginosis
Chlamydia trachomatis
Gonorrhoea
Pelvic Inflammatory Disease
Trichomoniasis
Candida, Genital Thrush
Anogenital Warts
Syphilis
Genital Herpes
Shigellosis
Skin/Soft Tissue
Oral/Dental
Safe Prescribing
Infection Prevention and Control
Drug Interactions
Hospital Related Guidelines
About us
Prescribing for Children