Chicken Pox / Shingles - Antibiotic Prescribing

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

  • If pregnant/immunocompromised seek advice. Dosing in the immunocompromised requires an extended course of antivirals.
  • Chicken pox: In immunocompetent, value of antivirals minimal unless severe pain, or adult, or on steroids, or secondary household case AND treatment started within 24h of onset of rash.A-
  • Shingles: Always treat if active ophthalmic infection, Ramsey Hunt or eczema.
  • Non-ophthalmic shingles: Treat if >50 yrs and within 72h of onset of rash, as post-herpetic neuralgia rare in <50 yrs but occurs in 20% >50 yrsA+


Treatment Dose TX Duration
First line aciclovir 800mg 5x/day 7 days
Second line if a compliance problem valaciclovir 1g TDS 7 days
OR famciclovir 500mg TDS 7 days

We recommend patients use the website developed by HSE/ICGP/IPU partnership 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.

Further information is available to view from the HPSC website

Reviewed June 2016