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Information for parents and carers

1. Why are we sharing this information?
The liquid forms of some antibiotics are currently not readily available. These antibiotics include
phenoxymethylpenicillin, amoxicillin, erythromycin, clarithromycin, azithromycin, cefalexin and
clindamycin.
So that your child gets the antibiotic they need, we may have to give their medicine in the form of
a tablet or capsule. You can use these to make a liquid or softer version of the medicine that your
child will find easier to swallow. You will be advised on what dose to give by the child’s doctor or
pharmacist. In the case of tablets this may be half of a tablet or a whole tablet. Where the dose
is for half of a tablet you may find that the tablet is scored and breaks easily. Tablet cutters can
be used to cut the tablet accurately. These are available from pharmacies.
2. How do I prepare the medicine for my child?
To avoid any skin problems and to avoid inhaling the antibiotic, always wear gloves and a
mask when you are preparing the antibiotic for your child.
If you are allergic to penicillin, cephalosporin or macrolide antibiotics, ask someone else to
prepare the medicine for your child. If you are unsure whether it is safe for you to do, ask
your pharmacist.
The advice below is for doses of half or whole tablets or whole capsules. If your child has been
prescribed a different dose please ask your pharmacist for advice on how to prepare and give the
dose.
If your child has been given capsules, you can open them and put the antibiotic powder inside
into water or mix it with soft food.
If your child has been given tablets, you can:
• put the whole or half tablet (depending on the dose) into water so that it breaks up and
disperses, then draw up the solution into in an oral (or enteral) syringe to give the dose.
• crush the whole or half tablet (depending on the dose), then put it into water or mix it with
soft food.
3. How do I disperse or crush the tablets?
Dispersing tablets to give your child a half or whole tablet dose
Using an oral syringe:
1. Place half a tablet or the whole tablet (depending on the dose) in a 10mL oral syringe.
2. Put the plunger back in and draw up about 5mL of water.
3. Take the syringe out of the water and draw up about 2mL of air.
4. Shake the syringe well and leave it until there are only tiny tablet particles in the liquid.
This could take up to 10 minutes.
Written December 2022, version 1 Page 2 of 2 Review date January 2023
Welsh Medicines Advice Service (WMAS) based on information by Medicines for Children and the Specialist Pharmacy Service
Using a small glass or medicine cup:
1. Put half a tablet or the whole tablet (depending on the dose) in a small glass or medicine
cup and add 5 to 10mL water.
2. Stir well and leave until there are only tiny particles of the tablet in the liquid. This could
take up to 10 minutes.
Crushing tablets to give your child a half or whole tablet dose
You can crush half of a tablet or a whole tablet (depending on the dose) between two spoons, or
you can use a pestle and mortar or tablet crusher (if you have one).
4. Administering the medicine to your child
The dispersed or crushed tablets and the capsule contents taste unpleasant. You can cover up
the taste by mixing them with a small amount of:
• a drink with a strong flavour, e.g. blackcurrant cordial, or
• soft food that your child likes, e.g. jam, apple sauce, yoghurt (about a teaspoonful)
Give the mixture straight away and try to make sure that your child takes the whole dose.
Use an oral syringe for liquids if your child finds this easier.
5. What do I do if my child has side effects?
As with all medicines, if your child experiences any side effects from their antibiotic, you should
report it to your doctor, nurse or pharmacist. You can also use the Yellow Card app (download
from Google Play or Apple App Store) or the Yellow Card site to report side effects.
Further advice
Medicines for Children provides further information on giving tablets
and capsules to children.
Off-label use of Medicines
Using medicines in the ways described above is ‘off-label’. This is because the regulatory
authority that approves medicines in the UK (the MHRA) has approved their use only if they are
taken as solid tablets or capsules. Medicines are only used off-label after careful consideration of
other available options. You can be confident that these options have been considered by the
team caring for your child.