Respiratory Infections 2023 Winter Season: Advice & Antibiotic Supply

Background

This page is made available to assist GPs, pharmacists and other healthcare professionals, access the most up-to-date information on the management of common respiratory infections during the 2022/2023 winter season. The information available on this page will be reviewed regularly by HSE-AMRIC & HPRA.

The advice below supplements current antimicrobial prescribing guidelines provided by the HSE for upper respiratory infections and lower respiratory infections.

The guidelines provide recommendations for the treatments of common respiratory conditions, including the choice of appropriate antibiotics and guidance on when delayed prescriptions could be used or when antibiotics may not be needed.

Suggestions to maximise the availability of antibiotics for those patients most likely to benefit from their use

When antibiotics may not be needed
  • For self-limiting and likely viral infections advise patients to use www.undertheweather.ie for advice on self-management.
  • Included in the national antibiotic prescribing guidelines linked above is expert advisory group advice for each condition and, where applicable, it indicates when an antibiotic is unlikely to impact the course of an infection and therefore most likely would not be needed.
Delayed prescriptions
  • For the Prescriber:
    When applicable use delayed prescriptions.  Advise patients of the need to protect antibiotic supply for those that really need an antibiotic and not to collect the antibiotic until they have followed the advice and decided they need to take the antibiotic.
  • For the Pharmacist:
    Check with patients presenting with delayed prescriptions that the patient is adhering to the prescriber recommendation of only requesting dispensing of the prescription for immediate consumption.

If an antibiotic is required

 Use of tablets/capsules for some children
  • Consider where possible using tablets/capsules for some children to prioritise supply of liquid formulations for the very young.
  • Consider rounding doses to the nearest capsule/tablet strength to facilitate administration of capsules/tablets.
  • For further guidance on helping children to swallow capsules/tablets consult the NHS Kidzmed leaflet.
Duration of treatment
  • Follow individual condition guidance linked above for the recommended durations of antibiotics.
 Liaise with local community pharmacies
  • Liaise with local community pharmacies to confirm which of the recommended antibiotics are available for prescribing. Include alternative antibiotic options on the prescription if required.

Current supply status of the most commonly used antibiotics for respiratory infections

Antibiotic Preferred antibiotic classification
status for community prescriptions
Supply status at distributor level*
Phenoxymethyl-penicillin Green
  • 250mg oral suspension - unavailable
  • Oral solid dose products – available
Cefalexin Green
  • 125mg oral suspension – available
  • 250mg oral suspension - unavailable
  • Oral solid dose forms - available
Amoxicillin Green
  • 125mg oral suspension - EMP# supply available
  • 250mg oral suspension – EMP# supply available
  • Oral solid dose forms – available
Doxycycline Green
  • Available
Co-amoxiclav Red
  • 125mg/31.25mg oral suspension – available
  • 400mg/57mg oral suspension – limited supply available**
  • Oral solid dose forms – available
Azithromycin Red
  • Oral suspension - unavailable
  • Oral solid dosage forms - available
Clarithromycin Red
  • 125mg oral suspension – available
  • 250mg oral suspension - unavailable
  • Oral solid dose forms – limited supply available**

*Where a product is not listed as a shortage on the HPRA website availability may differ across wholesale supply therefore a pharmacist may be required to check other distributors.

# EMP = exempt medical product. An exempt medicinal product (EMP) is a medicinal product that is not authorised or registered in Ireland

** “Limited supply available” indicates that certain strengths or presentations of the product may be unavailable. For more information on specific product shortages, please check the HPRA website.

Reviewed January 31st 2023

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