Doses are oral and for adults unless otherwise stated. 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). See guidance on dosing in children for quick reference dosage/weight guide. Refer to drug interactions table for detailed drug interactions for all antimicrobials. Note extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.
Note additional warnings for clarithromycin and fluoroquinolones
Comments from Expert Advisory Committee
- In primary care, antibiotics have marginal benefits in otherwise healthy adults. A+
- Patient leaflets can reduce antibiotic use. B+
- Low doses of penicillins are more likely to select out resistance.
- The quinolones ciprofloxacin and ofloxacin have poor activity against pneumococci. However, they do have use in PROVEN pseudomonal infections. Levofloxacin has some anti-Gram-positive activity but should not be needed as first line treatment
- Avoid tetracyclines in pregnancy
- Cough expectorants: guaifenesin
- Mucolytic agent: carbocisteine
- Cough suppressants: dextromethorphan
- Codeine containing products should be used with care due to dependence potential
Consider no antibiotics where possible. A+
If antibiotics deemed clinically indicated:
See guidance on dosing in children for quick reference dosage/weight guide
We recommend patients use the website developed by HSE/ICGP/IPU partnership www.undertheweather.ie for tips on how to get better from common infections without using antibiotics, what you can do for yourself or a loved one and when to seek help.
Reviewed Dec 2019
Visit HPSC Information Leaflets pages for the General Public, (MRSA, CRE, etc)