Penicillin V
Synonym :
Phenoxymethylpenicillin
Mechanism :
It is an oral penicillin. It interferes with cell wall synthesis in susceptible bacteria. It is used in treatment of gram-positive infections. IT is given orally for streptococcal pharyngitis, prophylaxis for rheumatic fever and in treatment of otitis media and sinusitis.
Indication :
- Streptococcal pharyngitis
- Rheumatic fever - secondary prophylaxis
- Community-acquired bacterial pneumonia
- Pneumococcal infection prophylaxis
Contraindications :
Anaphylactic reaction to beta-lactams.
Dosing :
Oral, give 1 hour before or 2 hours after meals.
Streptococcal pharyngitis:
<5 years: 250 mg PO bid-tid x 10 days;
>5 years: 500 mg PO bid-qid x 10 days.
Rheumatic fever: Secondary prophylaxis, Pneumococcal infection prophylaxis:
<5 years: 125 mg PO bid.
>5 years: 250 mg PO bid.
Community-acquired bacterial pneumonia:
>3 months: 50-75 mg/kg/day PO divided every 6-8 hours for 7-10 days.
Adverse Effect :
Rash, eosinophilia, allergy, seizures, nausea, diarrhea, oral candidiasis, anemia, anaphylaxis, interstitial nephritis, positive coomb’s reaction.
Interaction :
Interaction Characteristics:
Alters GI flora, bactericidal activity requires bacterial growth, lowers seizure threshold.
Contraindicated:
BCG live intravesical.
Avoid/Use Alternative:
Typhoid vaccine, live.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as normal renal function |
| HD | Dialysed. Dose as in normal renal function |
| HDF/High flux | Dialysed. Dose as in normal renal function |
| CAV/VVHD | Dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended.