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COVID-19 acute respiratory infection (Adults)

  • covid smallCOVID-19 is a viral infection.
  • Antivirals or agents with antiviral properties for COVID-19 should not be prescribed for treatment or prophylaxis in the community, unless as part of a clinical trial.
  • Secondary bacterial infection appears uncommon in COVID-19 patients.
  • Differentiating viral (COVID-19) versus bacterial pneumonia
    • Viral more likely if;
      • history of typical COVID-19 symptoms for about a week
      • severe muscle pain (myalgia),
      • loss of sense of smell (anosmia), taste (dysgeusia)
      • breathless but has no pleuritic pain
      • history of exposure to known or suspected COVID-19, such as a household or workplace contact.
    • Bacterial more likely if;
      • became rapidly unwell after only a few days of symptoms
      • does not have a history of typical COVID-19 symptoms
      • purulent sputum
      • underlying chronic lung disease with history of secondary bacterial infection in winters e.g. in acute infective exacerbation of COPD.
  • If antibiotics are prescribed remember:
    • Keep duration as short as possible
    • May cause side effects
    • Broad-spectrum antibiotics in particular may lead to Clostridioides difficile infection
    • Consider drug interactions
    • Consider renal impairment dose adjustment
    • Frail elderly patients are at greater risk of complication and death from all infections. Although there may be a lower threshold for prescribing antibiotics, older patients are also at greater risk of harm from antibiotics.

Treatment

covidNov2020table

* Alternative doxycycline dose: 100mg every 12 hours. 
In non-severe infection, 200mg stat then 100mg every 24 hours can be considered.

Patient Information

www.hse.ie/coronavirus

Safe Prescribing (visit the safe prescribing page)

Reviewed November 2020