Using solid oral dosage form antibiotics in children

Opening and dispersing

The capsules can be opened and the contents tipped out and mixed with liquid or soft food. This should not be performed by anyone with a penicillin allergy.

Masking the taste

The capsule contents will taste bitter. Consider using a strongly flavoured drink such as blackcurrant cordial or food such as jam, apple sauce or yoghurt that the child likes:

• use a small amount (a teaspoonful) of food or drink, so you can be sure the child swallows it all and gets the whole dose
• consider using an oral syringe for liquids
• after mixing the capsule content with food or drink, give it straight away

Opening and dispersing

The capsules can be opened and the contents tipped out and mixed with liquid or soft food. This should not be performed by anyone with a macrolide allergy.

Masking the taste

The capsule contents will taste bitter. Consider using a strongly flavoured drink such as blackcurrant cordial or food such as jam, apple sauce or yoghurt that the child likes:

• use a small amount (a teaspoonful) of food or drink, so you can be sure the child swallows it all and gets the whole dose
  
• consider using an oral syringe for liquids
• after mixing the powder with food or drink, give it straight away

Absorption of azithromycin capsules (but not tablets or oral suspension) can be decreased by food. However, it is not clear whether the absorption of opened capsules is affected.

Dispersing or crushing

The tablets are film-coated but can be dispersed in water or crushed and mixed with liquid or soft food. Crushing tablets should not be performed by anyone with a macrolide allergy.

Dispersing tablets

To disperse the tablet:

• place the tablet in the barrel of a 10mL oral syringe
• replace the plunger
• draw up approximately 5mL of water and 2mL of air
• shake well and allow to disperse (this may take up to 10 minutes)
• ensure all contents of the syringe are given

Alternatively, the tablet may be mixed with 5 to 10mL of water in a small glass or medicine cup and stirred well.

Masking the taste

The dispersed or crushed tablet will taste bitter. Consider using a strongly flavoured drink such as blackcurrant cordial or food such as jam, apple sauce or yoghurt that the child likes:

• use a small amount (a teaspoonful) of food or drink, so you can be sure the child swallows it all and gets the whole dose
• consider using an oral syringe for liquids
• after mixing the crushed tablet with food or drink, give it straight away

Opening and dispersing

The capsules can be opened and the contents tipped out and mixed with liquid or soft food. This should not be performed by anyone with a penicillin or cephalosporin allergy.

Masking the taste

The capsule contents will taste bitter. Consider using a strongly flavoured drink such as blackcurrant cordial or food such as jam, apple sauce or yoghurt that the child likes:

• use a small amount (a teaspoonful) of food or drink, so you can be sure the child swallows it all and gets the whole dose
  
• consider using an oral syringe for liquids
• after mixing the powder with food or drink, give it straight away

Dispersing or crushing

The tablets are film-coated but can be dispersed in water or crushed and mixed with liquid or soft food. Crushing tablets should not be performed by anyone with a penicillin or cephalosporin allergy.

Dispersing tablets

To disperse the tablet:

• place the tablet in the barrel of a 10mL oral syringe
• replace the plunger
• draw up approximately 5mL of water and 2mL of air
• shake well and allow to disperse (this may take up to 10 minutes)
• ensure all contents of the syringe are given

Alternatively, the tablet may be mixed with 5 to 10mL of water in a small glass or medicine cup and stirred well.

Masking the taste

The dispersed or crushed tablet will taste bitter. Consider using a strongly flavoured drink such as blackcurrant cordial or food such as jam, apple sauce or yoghurt that the child likes

• use a small amount (a teaspoonful) of food or drink, so you can be sure the child swallows it all and gets the whole dose
• consider using an oral syringe for liquids
• after mixing the crushed tablet with food or drink, give it straight away

Dispersing or crushing

The tablets are film-coated but can be dispersed in water or crushed and mixed with liquid or soft food. Crushing tablets should not be performed by anyone with a macrolide allergy. The modified-release tablets must not be crushed.

Dispersing tablets

To disperse the tablet:

• place the tablet in the barrel of a 10mL oral syringe
• replace the plunger
• draw up approximately 5mL of water and 2mL of air
• shake well and allow to disperse (this may take up to 10 minutes)
• ensure all contents of the syringe are given

Alternatively, the tablet may be mixed with 5 to 10mL of water in a small glass or medicine cup and stirred well.

Masking the taste

The dispersed or crushed tablet will taste bitter. Consider using a strongly flavoured drink such as blackcurrant cordial or food such as jam, apple sauce or yoghurt that the child likes:

• use a small amount (a teaspoonful) of food or drink, so you can be sure the child swallows it all and gets the whole dose
• consider using an oral syringe for liquids
• after mixing the crushed tablet with food or drink, give it straight away

Dispersing or crushing

The tablets are film-coated but can be dispersed in water or crushed and mixed with liquid or soft food. Crushing tablets should not be performed by anyone with a macrolide allergy. Enteric-coated tablets should not be crushed and will not disperse in water.

Dispersing tablets

To disperse the tablet:

• place the tablet in the barrel of a 10mL oral syringe
• replace the plunger
• draw up approximately 5mL of water and 2mL of air
• shake well and allow to disperse (this may take up to 10 minutes)
• ensure all contents of the syringe are given

Alternatively, the tablet may be mixed with 5 to 10mL of water in a small glass or medicine cup and stirred well.

Masking the taste

The dispersed or crushed tablet will taste bitter. Consider using a strongly flavoured drink such as blackcurrant cordial or food such as jam, apple sauce or yoghurt that the child likes:

• use a small amount (a teaspoonful) of food or drink, so you can be sure the child swallows it all and gets the whole dose
• consider using an oral syringe for liquids
• after mixing the crushed tablet with food or drink, give it straight away

Some generic products advise to give one hour before food. However, this may not be necessary and is not practical in this situation.

Opening and dispersing

The capsules can be opened and the contents tipped out and mixed with liquid or soft food. This should not be performed by anyone with penicillin allergy.

Masking the taste

The capsule contents will taste bitter. Consider using a strongly flavoured drink such as blackcurrant cordial or food such as jam, apple sauce or yoghurt that the child likes:

• use a small amount (a teaspoonful) of food or drink, so you can be sure the child swallows it all and gets the whole dose
  
• consider using an oral syringe for liquids
• after mixing the powder with food or drink, give it straight away

Although flucloxacillin is generally given on an empty stomach, a study in children found no difference in absorption when given with or without food.

Dispersing or crushing

The tablets are film-coated but can be dispersed in water or crushed and mixed with liquid or soft food. Crushing tablets should not be performed by anyone with a penicillin allergy.

Dispersing tablets

To disperse the tablet:

• place the tablet in the barrel of a 10mL oral syringe
• replace the plunger
• draw up approximately 5mL of water and 2mL of air
• shake well and allow to disperse (this may take up to 10 minutes)
• ensure all contents of the syringe are given

Alternatively, the tablet may be mixed with 5 to 10mL of water in a small glass or medicine cup and stirred well.

Masking the taste

The dispersed or crushed tablet will taste bitter. Consider using a strongly flavoured drink such as blackcurrant cordial or food such as jam, apple sauce or yoghurt that the child likes:

• use a small amount (a teaspoonful) of food or drink, so you can be sure the child swallows it all and gets the whole dose
• consider using an oral syringe for liquids
• after mixing the crushed tablet with food or drink, give it straight away

Phenoxymethylpenicillin would normally be given half an hour before food as food slightly decreases the peak plasma concentration of the drug. However, the manufacturer acknowledges that food does not appear to affect the extent of absorption.