Penicillin Uses

• Penicillin indications
• Uses of Penicillin in details
• Penicillin description
• Penicillin dosage
• Penicillin interactions
• Penicillin side effects
• Penicillin contraindications

What is Penicillin?

Penicillins are used to treat infections caused by bacteria. They work by killing the bacteria or preventing their growth.

There are several different kinds of penicillins. Each is used to treat different kinds of infections. One kind of penicillin usually may not be used in place of another. In addition, penicillins are used to treat bacterial infections in many different parts of the body. They are sometimes given with other antibacterial medicines (antibiotics). Some of the penicillins may also be used for other problems as determined by your doctor. However, none of the penicillins will work for colds, flu, or other virus infections.

Penicillins are available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, penicillins are used in certain patients with the following medical conditions:

• Chlamydia infections in pregnant women—Amoxicillin and ampicillin
• Gas gangrene—Penicillin G
• Helicobacter pylori-associated gastritis or peptic ulcer disease—Amoxicillin
• Leptospirosis—Ampicillin and penicillin G
• Lyme disease—Amoxicillin and Penicillin
• Typhoid fever—Amoxicillin and ampicillin

Penicillin indications

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Penicillin Potassium and other antibacterial drugs, Penicillin Potassium should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Penicillin Potassium tablets are indicated in the treatment of mild to moderately severe infections due to penicillin G-sensitive microorganisms. Therapy should be guided by bacteriologic studies (including sensitivity tests) and by clinical response.

NOTE: Severe pneumonia, empyema, bacteremia, pericarditis, meningitis, and arthritis should not be treated with Penicillin during the acute stage. Indicated surgical procedures should be performed.

The following infections will usually respond to adequate dosage of Penicillin.

Streptococcal Infections (without bacteremia)

Mild-to-moderate infections of the upper respiratory tract, scarlet fever, and mild erysipelas.

NOTE: Streptococci in groups A, C, G, H, L, and M are very sensitive to penicillin. Other groups, including group D (enterococcus), are resistant.

Pneumococcal Infections

Mild to moderately severe infections of the respiratory tract.

Staphylococcal infections – penicillin G-sensitive

Mild infections of the skin and soft tissues.

NOTE: Reports indicate an increasing number of strains of staphylococci resistant to penicillin G, emphasizing the need for culture and sensitivity studies in treating suspected staphylococcal infections.

Fusospirochetosis (Vincent’s gingivitis and pharyngitis)

Mild to moderately severe infections of the oropharynx usually respond to therapy with oral penicillin.

NOTE: Necessary dental care should be accomplished in infections involving the gum tissue.

Medical conditions in which oral penicillin therapy is indicated as prophylaxis: For the prevention of recurrence following rheumatic fever and/or chorea: Prophylaxis with oral penicillin on a continuing basis has proven effective in preventing recurrence of these conditions.

Although no controlled clinical efficacy studies have been conducted, Penicillin has been suggested by the American Heart Association and the American Dental Association for use as an oral regimen for prophylaxis against bacterial endocarditis in patients who have congenital heart disease or rheumatic or other acquired valvular heart disease when they undergo dental procedures and surgical procedures of the upper respiratory tract1.

Oral penicillin should not be used in those patients at particularly high risk for endocarditis (e.g., those with prosthetic heart valves or surgically constructed systemic pulmonary shunts). Penicillin should not be used as adjunctive prophylaxis for genitourinary instrumentation or surgery, lower-intestinal tract surgery, sigmoidoscopy, and childbirth. Since it may happen that alpha hemolytic streptococci relatively resistant to penicillin may be found when patients are receiving continuous oral penicillin for secondary prevention of rheumatic fever, prophylactic agents other than penicillin may be chosen for these patients and prescribed in addition to their continuous rheumatic fever prophylactic regimen.

NOTE: When selecting antibiotics for the prevention of bacterial endocarditis, the physician or dentist should read the full joint statement of the American Heart Association and the American Dental Association1.

How should I use Penicillin?

Use Penicillin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Penicillin is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Penicillin at home, a health care provider will teach you how to use it. Be sure you understand how to use Penicillin. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
• Do not use Penicillin if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
• Penicillin works best if it is given at the same time each day.
• Penicillin is injected into a muscle. Penicillin should not be injected into or near an artery or vein.
• To clear up your infection completely, use Penicillin for the full course of treatment. Keep using it even if you feel better in a few days.
• Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
• If you miss a dose of Penicillin and you are using it regularly, use it as soon as possible. If it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Penicillin.

Uses of Penicillin in details

Use: Labeled Indications

Fusospirochetosis (Vincent gingivitis and pharyngitis): Treatment of fusospirochetosis (Vincent gingivitis and pharyngitis), in conjunction with dental care for infections involving gum tissue.

Pneumococcal infections: Treatment of mild to moderately severe pneumococcal respiratory tract infections, including otitis media.

Rheumatic fever and/or chorea prophylaxis: Prophylaxis (chronic, secondary) of rheumatic fever and/or chorea.

Staphylococcal infections (penicillin G-sensitive): Treatment of mild infections of the skin and soft tissues.

Streptococcal infections (without bacteremia): Treatment of mild to moderate streptococcal infections of the upper respiratory tract, scarlet fever, and mild erysipelas.

Off Label Uses

Actinomycosis

Data from a limited number of clinical studies suggest that Penicillin potassium may be beneficial for the treatment of actinomycosis after initial surgical intervention and IV therapy with penicillin G (if clinically indicated).

Streptococcus (group A) chronic carrier

Based on the Infectious Diseases Society of America (IDSA) Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis, Penicillin potassium given to chronic carriers of group A streptococcal is effective and recommended in the management of this condition.

Penicillin description

A broad-spectrum penicillin antibiotic used orally in the treatment of mild to moderate infections by susceptible gram-positive organisms.

Penicillin dosage

The dosage of Penicillin should be determined according to the sensitivity of the causative microorganism and the severity of infection, and adjusted to the clinical response of the patient.

The usual dosage recommendations for adults and children 12 years and over are as follows:

Streptococcal Infections

Mild to moderately severe - of the upper respiratory tract and including scarlet fever and erysipelas: 125 to 250 mg (200,000 to 400,000 units) every 6 to 8 hours for 10 days.

Pneumococcal Infections

Mild to moderately severe - of the respiratory tract, including otitis media: 250 to 500 mg (400,000 to 800,000 units) every 6 hours until the patient has been afebrile for at least 2 days.

Staphylococcal Infections

Mild infections of skin and soft tissue (culture and sensitive tests should be performed): 250 to 500 mg (400,000 to 800,000 units) every 6 to 8 hours.

Fusospirochetosis (Vincent’s infection) of the oropharynx. Mild to moderately severe infections: 250 to 500 mg (400,000 to 800,000 units) every 6 to 8 hours.

For the prevention of recurrence following rheumatic fever and/or chorea: 125 mg to 250 mg (200,000 to 400,000 units) twice daily on a continuing basis.

For prophylaxis against bacterial endocarditis1 in patients with congenital heart disease or rheumatic or other acquired valvular heart disease when undergoing dental procedures or surgical procedures of the upper respiratory tract: 2 gram of Penicillin (1 gram for children under 60 lbs.) 1 hour before the procedure, and then, 1 gram (500 mg for children under 60 lbs.) 6 hours later.

Penicillin interactions

See also:
What other drugs will affect Penicillin?

Amoxicillin may decrease the effectiveness of contraceptives for oral administration.

With the simultaneous use of Penicillin Vista Health Care with bactericidal antibiotics (including aminoglycosides, cephalosporins, cycloserine, vancomycin, rifampicin) appears synergies; with bacteriostatic antibiotic (including macrolides, chloramphenicol, lincosamides, tetracyclines, sulphonamide) - antagonism.

Amoxicillin increases the effects of indirect anticoagulants inhibiting intestinal microflora, reduces the synthesis of vitamin K and prothrombin index.

Amoxicillin reduces the effect of drugs, in the process of metabolism that produce PABA.

Probenecid, diuretics, allopurinol, phenylbutazone, NSAIDs decrease the tubular secretion of amoxicillin, which can be accompanied by an increase in its concentration in blood plasma.

Antacids, glucosamine, laxatives, aminoglycosides, slow down and reduce, and ascorbic acid increases the absorption of amoxicillin.

With the combined use of amoxicillin and clavulanic acid pharmacokinetics of both components unchanged.

Penicillin side effects

See also:
What are the possible side effects of Penicillin?

Applies to Penicillin potassium: capsule, powder for solution, powder for suspension, solution, suspension, syrup, tablet, tablet for suspension, tablet chewable, tablet extended release

As well as its needed effects, Penicillin potassium may cause unwanted side effects that require medical attention.

Stop taking Penicillin potassium and get emergency help immediately if any of the following effects occur:

Less common:

• Fast or irregular breathing
• fever
• joint pain
• lightheadedness or fainting (sudden)
• puffiness or swelling around the face
• red, scaly skin
• shortness of breath
• skin rash, hives, itching

Major Side Effects

If any of the following side effects occur while taking Penicillin potassium, check with your doctor immediately:

Rare

• Abdominal or stomach cramps and pain (severe)
• abdominal tenderness
• convulsions (seizures)
• decreased amount of urine
• diarrhea (watery and severe), which may also be bloody
• mental depression
• nausea and vomiting
• pain at place of injection
• sore throat and fever
• unusual bleeding or bruising
• yellow eyes or skin

• Agitation or combativeness
• anxiety
• confusion
• fear of impending death
• feeling, hearing, or seeing things that are not real

Minor Side Effects

Some Penicillin potassium side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:

• Diarrhea (mild)
• headache
• sore mouth or tongue
• vaginal itching and discharge
• white patches in the mouth and/or on the tongue

Penicillin contraindications

See also:
What is the most important information I should know about Penicillin?

A history of a previous hypersensitivity reaction to any of the penicillins is a contraindication. Penicillin is also contraindicated in infections caused by penicillinase-producing organisms.

Active ingredient matches for Penicillin:

Penicillin V in Hungary, Malta, Poland, United States.

Benzylpenicillin in Hungary, Poland, United States.

Phenoxymethylpenicillin in Malta.

References

1. DailyMed. "PENICILLIN V POTASSIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
2. PubChem. "penicillin v". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
3. DrugBank. "penicillin v". http://www.drugbank.ca/drugs/DB00417 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology