Lower Respiratory Tract Infection |
First Line |
Second Line |
Allergy status
(Confirm allergy status prior to choosing antimicrobial regime) |
No penicillin allergy
|
|
Antimicrobial
Check for interactions |
Amoxicillin |
Doxycycline* |
Dose |
1000mg every 8 hours |
200mg stat, then 100mg every 12 hours |
Route |
Oral |
Oral |
Duration |
5 days |
*Doxycycline
is ineffective if given with multi-valent cation containing products e.g.
antacids, supplements or feeds containing calcium, iron, magnesium, zinc,
sucralfate or bismuth. These products bind to doxycycline and reduce its
absorption by up to 90%.
If patients are prescribed antacids
or supplements containing calcium iron, magnesium zinc or bismuth. It is
advised these medications are stopped/withheld for the duration of antibiotic
treatment. If this is not possible due to a clinical need, then an alternative
antibiotic must be considered.
If doxycycline and a cation
containing product must be prescribed together:
· Administration
times should be as far apart as possible
· Reduce
the dosing frequency of the interacting product if possible
· In the case of oral nutritional
supplements, multiple sips throughout the day should be replaced with set
administration times to enable adequate spacing from oral antibiotic
administration
· If a patient is receiving an enteral
feed doxycycline should generally be avoided unless there is a specific feed
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