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Whats New on Antibiotic Prescribing

Recently updated content on the website

  • Respiratory tract infections February 2021
    • For pregnancy, if macrolide considered necessary, azithromycin added as an option for all trimesters.
  • Pregnancy and Postpartum infections February 2021
    • Additional Patient information resources added to all sections
    • Additional Healthcare Professional information resources added to Prescribing Antimicrobials in Pregnancy and Lactation page
  • Asymptomatic Bacteriuria in Pregnancy new content! February 2021
    • Advice on when and how to test for and treat asymptomatic bacteriuria in pregnancy
    • Urine culture remains the gold standard for detection of asymptomatic bacteriuria
    • Dipstick testing is not sufficient to screen for bacterial UTIs in pregnancy.
    • Drug treatment based on the bacteria isolated in urine culture and trimester of pregnancy
  • Nipple and breast thrush: February 2021
    • The use of all-purpose nipple ointment is not recommended as treatment option.
    • Additional information points on use of miconazole for mother and baby.
  • Helicobacter pylori: December 2020
    • H. Pylori duration of treatment for all treatment regimens has been increased from 7 days to 14 days in line with published national guidelines.
    • A Bismuth quadruple regimen, if available, has been added as a 1st line treatment option. A levofloxacin regimen has also been added but should be reserved as a 2nd line option for failed treatment eradication.
  • Pharyngitis/ sore throat / tonsillitis: December 2020
    •  Cefalexin is an option for non-severe penicillin allergy, if antibiotic deemed necessary.
    •  Majority are viral however if antibiotics deemed necessary, recommended duration now 5 days (instead of 10 days)
  • Lyme Disease, Nov 2020
    • Criteria for post-exposure prophylaxis updated
  • Seasonal Influenza, Nov 2020
    • Seasonal Influenza page updated for 2020/2021 season. 
    • Duration of treatment for oseltamivir in immunocompromised patients changed to 10 days. 
    • Links to Coronavirus COVID-19 information added.  
  • COVID-19 acute respiratory infection, Nov 2020
    • Link to HSE COVID-19 repository added
    • Updated re advice on penicillin allergy in pregnancy.
  • Upper Respiratory Tract Infections, Nov 2020
    • Pharnygitis: Majority are viral however if antibiotics deemed necessary, recommended duration now 5 days (instead of 10 days)
    • Sinusitis (adults): Majority are viral however if antibiotics deemed necessary, doxycycline (first line if penicillin allergy) can be dosed at 200mg daily.
  • Lower Respiratory Tract Infections Nov 2020
    • Doxycycline (often first line if penicillin allergy) can be dosed at 200mg daily across the range of lower respiratory tract infections.
    • Duration of recommended therapy for community-acquired pneumonia reduced; 5 days for CRB-65 score 0 (instead of 5-7days), 7 days for CRB-65 score 1-2 (instead of 7-10 days)
    • Recommend higher dose amoxicillin (1g tds as opposed to 500mg tds) for community-acquired pneumonia CRB-65 score 1-2
  • New content to support deprescribing UTI prophylaxis, Nov 2020
    • All UTI prophylaxis should be reviewed at 3-6mths with a view to stopping as many patients can stop without a return of symptoms.
    • There is no evidence of additional benefit beyond 3-6 months but there is significant evidence of harm.
  • About Us, Nov 2020
    • Contact details for community antimicrobial pharmacists added.
    • List of contributors updated

whatsnew

  • Renal Impairment Summary Sept 2020
    • Medicines list expanded to include anti-fungals and anti-helmintics
    • Advice on Fosfomycin updated (avoid if CrCl <10ml/min)
    • Advice on Nitrofurantoin updated (contraindicated if CrCl <30ml/min, caution in use if CrCl 30-45ml/min)
  • Animal and Human Bites Sept 2020 
    • Content of both pages merged
    • Expanded advice on general management and antibiotic prophylaxis
    • Duration of prophylaxis 5 days, duration of treatment 7 days
  • COVID-19 acute respiratory infection May 2020
    • COVID-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.

  • Key messages from AMRIC to community prescribers March 2020
    • Tips on safe us of clarithromycin , and important safety concerns for fluoroquinolones especially moxifloxacin are just some of the items covered
  • Recurrent UTI in Adult, Non-Pregnant Females March 2020
    • This guideline refers to symptomatic culture-proven recurrent urinary tract infection (UTI)
      It covers non antimicrobial measures, antibiotic prophylaxis. It is important to remember that recurrent or persistent lower urinary tract symptoms are not always due to recurrent UTI. Other conditions such as STI, postmenopausal atrophic vaginitis and dermatological conditions often cause similar symptoms.
      Antimicrobial prophylaxis should be reviewed after 3-6 months with a view to stopping