Influenza in Pregnancy - Antibiotic Prescribing

Comment from expert advisory group

• Full guidance on influenza treatment on this website
• The patient should be referred to hospital for assessment if there is any respiratory compromise or suspicion of a bacterial super-infection
• Pregnancy (including up to two weeks postpartum) is in the Defined Risk Groups for Antivirals – at high risk of complicated influenza
• Antivirals are recommended for pregnant women due to the adverse clinical outcomes that have been observed for influenza in this group. Oseltamivir remains the first line option for the vast majority of pregnant women with influenza, including during seasons that are dominated by influenza A (H1N1)
• HPSC influenza advice during pregnancy

Treatment

Patient Information

• Visit HPSC Information Leaflets pages for the General Public, (MRSA, CRE, etc)
• Further information on Seasonal Flu Vaccine (HSE website)
• Flu and Coronavirus: The symptoms of coronavirus are like flu symptoms. The main difference is that you usually do not have shortness of breath when you have the flu. Compare symptoms of coronavirus, cold and flu. 
• Further information on Coronavirus COVID-19 
• We recommend patients use the website developed by HSE/ICGP/IPU partnership www.undertheweather.ie for tips on how to get better from common infections without using antibiotics, what you can do for yourself or a loved one and when to seek help.

Safe Prescribing (visit the safe prescribing page)

• Doses are oral and for adults unless otherwise stated
• Dosing in children quick reference dosage/weight guide
• Renal impairment dosing table
• Safety in Pregnancy and Lactation
• Drug interactions table. Extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.
• Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC).

Reviewed May 2022