YouTube video: ‘AMS microlearning for community pharmacists — childhood infections’ from HSE, click on QR code to view.
Designed for quick, flexible learning, the videos are available via single‑click access on YouTube and provide convenient CPD for busy healthcare professionals.
Antibiotics are often lifesaving, but their use in children requires particular care. Increasing evidence shows that repeated antibiotic exposure in early childhood can disrupt the microbiome — the community of beneficial microbes in the gut. These changes have been associated with longer‑term health risks, including obesity, asthma and type 1 diabetes. The goal of modern medicine is not avoiding antibiotics, but using them appropriately, in line with evidence‑based guidance, to maximise benefit and minimise harm.
If antibiotics are indicated for a particular infection, narrow‑spectrum antibiotics (referred to in Ireland as green antibiotics) should be used first‑line whenever possible. Children are less likely than adults to carry resistant bacteria, making narrow‑spectrum therapy both effective and appropriate. See antibioticprescribing.ie > community guidelines for the latest national antibiotic prescribing guidelines for the community setting.
Optimising dosing is another critical factor. Paediatric antibiotic dosing should generally be weight‑based (mg/kg) and may vary by age. Incorrect dose or frequency can result in either underdosing (can cause treatment failure and increased risk of AMR) or overdosing (can cause unnecessary antimicrobial exposure and increased risk of adverse effects). Pharmacists play a key role in ensuring accurate dosing, frequency and duration. Up‑to‑date paediatric dosing tables for commonly prescribed antibiotics are available at antibioticprescribing.ie>community guidelines > paediatric dosing tables.
Acute otitis media (AOM) is one of the most common childhood infections. Importantly, around 80 per cent of cases resolve within three days without antibiotics. AOM is usually viral. But even if it is of bacterial cause, it is usually self-limiting. Evidence shows that antibiotics make little difference to symptom duration and have minimal impact on recurrence, hearing loss or complications.
AMRIC guidelines recommend no antibiotics or a delayed (‘back‑up’) prescription for most children over two years of age, and for younger children with mild unilateral infection and no ear discharge. Immediate antibiotics are reserved for specific cases, such as children under two with bilateral infection or those with otorrhoea due to a perforated eardrum. See guideline for full information.
Community pharmacists are central to managing AOM without antibiotics by advising on effective pain relief, explaining appropriate analgesic dosing schedule and reassuring parents that symptoms usually improve within a few days. Parents should be advised to seek medical review if symptoms worsen or fail to improve.
Most sore throats in children are viral, with symptoms typically resolving within seven days. The antibiotic prescribing guidelines recommend that prescribers use FeverPAIN scoring system to identify those most likely to benefit from antibiotics. The microlearning video explains FeverPAIN in detail and how it supports prescribing decisions.
As with ear infections, community pharmacists can guide families on analgesia, hydration, self‑care and safety‑netting, helping to reduce unnecessary antibiotic use.
When tested with community pharmacists, feedback on the microlearning format was overwhelmingly positive: 100 per cent would recommend it to a colleague, with all participants rating it useful or extremely useful (n=8).
Watch the video to explore these topics in more depth and strengthen your role in safe, evidence‑based treatment of childhood infections.
Ellen Martin, Senior Pharmacist and Marie Philbin, Chief I Pharmacist, HSE Antimicrobial Resistance and Infection Control (AMRIC) team
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