The NHS has issued new guidance on using solid oral dosage form antibiotics in children amid concerns about shortages of some antibiotic medicines.

The guidance, issued by Shaheen Sidik of the Specialist Pharmacy Service yesterday (December 7), states: “Whole doses of solid oral dosage forms can be used ‘off-label’ in place of oral suspensions.

“This includes use for Group A streptococcal (GAS) infections.”

The guidance recommends that children “should be encouraged” to swallow solid dose forms such as tablets and capsules “where possible,” but can be given dispersed or crushed tablets, or opened capsules, if they are unable to swallow whole doses.

The guidance offers advice on tablet and/or capsule forms that are available for medicines including Penicillin V, clarithromycin, erythromycin, amoxicillin and azithromycin.

It says how each product can be dispersed and the taste masked to make the medicine easier to give to children who need it. 

The new guidance comes amid rising concern from pharmacists unable to source key antibiotics from their mainline wholesalers after the Government issued new prescribing guidelines in response to worries about strep A cases in children, with a fifteenth death since September announced this afternoon.

The Government denies being aware of any supply issues around antibiotics used to treat GAS infection, angering many pharmacists who complain that these medicines – particularly liquid penicillin products – are difficult or impossible to obtain.