Table. Recommended antibiotic prescribing for common bacterial infections *.
| Diagnosis | Indications for antibiotic therapy | First-line antimicrobial (if indicated) | Duration | Tablets (for maximum adult dose) |
|---|---|---|---|---|
| Acute tonsillopharyngitis | 2–25 years, high risk of acute rheumatic fever, or rheumatic heart disease, or scarlet fever | Phenoxymethylpenicillin 12-hourly | 10 days † | 20 x 500 mg |
| Acute rhinosinusitis | Symptoms >7 days, or high fever >3 days, or biphasic illness | Amoxicillin 8-hourly | 5 days † | 15 x 500 mg |
| Acute otitis media | <6 months old, or systemic symptoms, or indigenous community | Non-indigenous: amoxicillin 12-hourly Indigenous: amoxicillin 12-hourly |
5 days † 7 days † |
20 x 500 mg 28 x 500 mg |
| Community-acquired pneumonia (mild, can review progress in 48 hours) | - | Adults: amoxicillin 8-hourly, or doxycycline 12-hourly Children: • 1 month to <3 months: azithromycin daily ‡ • 3 months to <5 years: amoxicillin 8-hourly • 5 years or older: amoxicillin 8-hourly § |
5–7 days# 3–5 days 3–5 days † 3–5 days † |
30 x 500 mg / 10 x 100 mg – – – |
| Uncomplicated urinary tract infection | - | Non-pregnant women: trimethoprim daily Pregnant women: cefalexin or nitrofurantoin 12-hourly Men: trimethoprim daily Children ≥1 month: trimethoprim/ sulfamethoxazole 12-hourly |
3 days 5 days 7 days 3–5 days ¶ |
3 x 300 mg 10 x 500 mg / 10 x 100 mg 7 x 300 mg – |
| Cellulitis (mild, low risk for methicillin-resistant Staphylococcus aureus) | - | Dicloxacillin or flucloxacillin 6-hourly, or phenoxymethylpenicillin 6-hourly ** |
5 days †† 5 days † , †† |
20 x 500 mg 20 x 500 mg |
| Impetigo | - | Non-remote setting: • Localised lesion: topical mupirocin • Multiple lesions/recurrent: dicloxacillin or flucloxacillin 6-hourly Remote setting: • trimethoprim/sulfamethoxazole 12-hourly, or • benzathine penicillin intramuscular |
7 days 3–10 days ‡‡ 5 days single dose |
– 40 x 500 mg 10 x 160/800 mg – |
| Abscess (low risk for methicillin-resistant Staphylococcus aureus) | Spreading cellulitis, or systemic symptoms, or large lesion/critical area | Dicloxacillin or flucloxacillin 6-hourly, as an adjunct to incision and drainage | 5 days | 20 x 500 mg |
* As recommended by Therapeutic Guidelines: Antibiotic. Refer to the complete guideline for further information on indications for antibiotic dosing, second-line antibiotics, and when broader spectrum therapy and specialist involvement may be appropriate. Refer also to local guidelines. Use oral regimen unless indicated otherwise.
† Repeat script required only if using liquid formulation for a large child.
‡ Chlamydia trachomatis may be the cause in this age group if afebrile and only mildly unwell.
§ Atypical cover with doxycycline, azithromycin or clarithromycin is recommended if Mycoplasma pneumoniae or another atypical pathogen is suspected. Doxycycline should not be used in children younger than 8 years of age.
# Repeat prescription required only if using amoxicillin.
¶ 5 days for children <1 year, 3 days for children ≥1 year.
** If Streptococcus pyogenes clinically suspected or isolated from culture.
†† Up to 10 days if cellulitis more severe.
‡‡ Stop therapy earlier than 10 days if infection has resolved.