Phenoxymethylpenicillin

When ATH:
J01CE02

Characteristic

Natural antibiotic from the penicillin group to enteral administration. Phenoxymethylpenicillin (fenoksimetilpenitsillinovaya acid) producing fungus Penicillium noted or a variety of related microorganisms. Is acid, destroyed by penicillinase.

The white crystalline powder sour-bitter taste. Hygroscopic. Very slightly soluble in water, soluble in methanol and ethanol, acetone, xloroforme, glycerin. IN 1 mg contains 1610 ED.

Used as benzathine penicillin and potassium salt.

Pharmacological action

Antibacterial, bactericide.

Application

Treatment and prevention of infections, caused by susceptible microorganisms: infections of the upper and lower respiratory tract (bronchitis, pneumonia, bronchopneumonia - except for cases, requiring parenteral penicillin); infection of upper respiratory tract (Diphtheria, tonsillitis, pharyngitis, laringit, otitis media, sinusitis), oral (periodontitis, Bacterial canker, actinomycosis); infections of skin and soft tissue (mug, erysipeloid, contagious impetigo, Chronic erythema migrans, furunculosis, abscess, flegmona); gonorrhea, syphilis, stolbnyak, anthrax, botulism, scarlet fever, leptospirosis, lymphatitis (lymphadenitis). Prevention of bacterial infections after surgery in frail patients, recurrence of rheumatic fever, rheumatoid arthritis, recurrence of pneumococcal meningitis after traumatic brain injury, pneumococcal infection in children after splenectomy or hypoalbuminemia, Bacterial endocarditis, glomerulonephritis, small chorea.

Contraindications

Hypersensitivity, incl. other penicillins; severe infections, incl. acute stage of severe pneumonia, empyema, perikardit, arthritis; thrush and pharyngitis; severe gastrointestinal disease, accompanied by vomiting and diarrhea.

Pregnancy and breast-feeding

Maybe, if the expected benefit to the mother outweighs the potential risk to the fetus or child.

Side effects

Allergic reactions: itch, hives, dermahemia, rhinitis, conjunctivitis, bronchospasm, erythema multiforme, exfoliative dermatitis, fever, arthralgia, angioedema, anaphylactic shock, anaphylactoid reactions.

From the digestive tract: anorexia, nausea, vomiting, flatulence, diarrhea, dry mouth, taste disturbance, glossitis, stomatitis, vesicular cheilitis (associated with the irritating effect on mucous membranes), psevdomembranoznыy colitis.

Cardio-vascular system and blood (hematopoiesis, hemostasis): leukopenia, agranulocytosis, thrombocytopenia, eozinofilija, gemoliticheskaya anemia, pancytopenia.

Other: interstitial nephritis, pharyngitis, vasculitis, superimposed infection.

Cooperation

Bactericidal antibiotics (incl. cephalosporins, cycloserine, vancomycin, rifampicin, aminoglikozidy) - Synergism, bacteriostatic antibacterials (incl. makrolidы, chloramphenicol, lincosamides, tetracikliny) - Antagonizm. When combined with allopurinol, NSAID - the canal secretion decreases and the concentration of phenoximethylpenicillin increases. It improves the effectiveness of anticoagulants by suppressing the intestinal microflora and reducing prothrombin index. Reduces the effect of oral contraceptives. Simultaneous treatment with allopurinol increases risk of allergic reactions (skin rash). Antacids, Glucosamine, laxatives, aminoglycosides slow down and reduce absorption; ascorbic acid - increases.

Dosing and Administration

Inside (for 0.5-1 hours before a meal). The dosing regimen and the duration of treatment are determined individually depending on the nature of the disease, age and eg. The average single dose for adults and children is older 12 years - 0.25-0.5 g, daily - 1,5 g and more. In the treatment of penicillin oral preparations, it is usually recommended to divide the total daily dose into 2-3 doses. Children up 1 year in a daily dose - 20-30 mg/kg, from 1 Year to 6 years - 15-30 mg/kg, from 6 to 12 years - 10–20 mg/kg. The course of treatment is usually 5-7 days. Treatment must be continued within 3 days after the disappearance of the symptoms. To prevent complications in patients with streptococcal infections, treatment should continue at least 10 days. For the prevention of postoperative bacterial complications to adults and children. 30 kg and more than 30-60 minutes before surgery - 2 g, then - 0,5 g every 6 h for 2 days or longer.

Precautions

In patients with a certain increased sensitivity to cephalosporins, possible cross allergies should be borne in mind. With the development of allergic reactions in patients receiving the drug should be discontinued.

With caution, patients with allergic diathesis should be prescribed, asthma.

With the alleged staphylococcal infection, bacteriological studies are recommended. Before conducting scheduled surgical interventions (Tonsillectomy, tooth extraction, etc.), In the postoperative period in patients, receiving penicillin for the purpose, It is necessary to double the dose.

Phenoximethylpenicillin should not be prescribed for violations of absorption from the digestive tract.

During therapy, it is recommended to control the composition of the blood, liver and/or kidneys. With prolonged treatment, it should be borne in mind the potential for the growth of stable strains of microorganisms, mushrooms and development of pseudo -dimensional colitis (The drug should be stopped and based on the results of a bacteriological examination, prescribed appropriate treatment; Taking antiperistaltic drugs is contraindicated).

In severe pneumonia, Empimema, sepsis, pericarditis, meninges, Arthritis and osteomyelite, in acute stage, a transition to parenteral administration of penicillins is needed. In combination with other antibiotics with a proven synergistic effect, the dose of a more toxic drug can be reduced. In patients with anuria, the dose should be reduced or it is necessary to increase the interval between the methods of the drug.

Cooperation