Penicillin V: Difference between revisions
Line 45: Line 45:
**Max: 2000 mg/day<ref>Shulman, 2012</ref>
**Max: 2000 mg/day<ref>Shulman, 2012</ref>
*Recurrent Rheumatic Fever, prophylaxis
*Recurrent Rheumatic Fever, prophylaxis
**250mg BID<ref>Gerber, 2009</ref>
**250mg BID<ref>4.Gerber MA, Baltimore RS, Eaton CB, et al, "Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal pharyngitis: A Scientific Statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics," Circulation, 2009, 119(11):1541-51. PubMed 19246689</ref>


===[[Anthrax]] (Cutaneous)===
===[[Anthrax]] (Cutaneous)===

Revision as of 21:53, 7 April 2014

General

  • Type: Natural Penicillin
  • Dosage Forms: PO 250mg, 500mg; 125mg/5mL, 250 mg/5 mL
  • Common Trade Names:

Adult Dosing

Strep Pharyngitis[1]

  • Acute
    • 250mg QID or 500mg BID x 10 days
  • Chronic carrier (Group A)
    • 500mg QID x 10 days + rifampin
    • Max: 2000 mg/day

Actinomycosis

  • Mild
    • 2000-4000mg PO divided q6 hours x 8 weeks
  • Surgical
    • I.V. Penicillin G x 4-6 weeks, then 2000-4000 mg PO divided q6h x 6-12 months

Erysipelas

  • 500mg PO QID

Recurrent Rheumatic Fever (Prophylaxis)

  • 250mg PO BID

Prosthetic Joint Infection, Chronic Suppression (Offlabel)[2]

  • 500mg BID-QID

Pediatric Dosing

General

  • <12 years
    • 25-50 mg/kg/day divided q6-8 hours
    • Max: 2000 mg/day
  • ≥12 years
    • 125-500mg q6-8 hours
    • Alt: 25-50 mg/kg/day divided q6-8 hours
    • Max: 2000 mg/day

Strep Pharyngitis

  • Acute[3]
    • ≤27kg: 250mg BID-TID x 10 days
    • >27kg: 500mg BID-TID x 10 days
  • Chronic Carrier (Group A streptococci
    • 50 mg/kg/day divided q6 hours x 10 days + rifampin
    • Max: 2000 mg/day[4]
  • Recurrent Rheumatic Fever, prophylaxis

Anthrax (Cutaneous)

  • 25-50 mg/kg/day divided BID-QID
  • Max: 500mg per dose (Stevens, 2005)


Pneumococcal infection prophylaxis for anatomic or functional asplenia [eg, sickle cell disease (SCD)] (AAP, 2000; AAP, 2002; Kavanagh, 2011; NHLBI, 2002): Oral: Infants and Children:

Before 2 months of age (or as soon as SCD diagnosed or asplenia occurs) to 3 years of age: 125 mg twice daily

>3 years: 250 mg twice daily; the decision to discontinue penicillin prophylaxis after 5 years of age in children who have not experienced invasive pneumococcal infection and have received recommended pneumococcal immunizations is patient and clinician dependent; Note: Some clinicians recommend in patients <5 years, a lower dose of 125 mg twice daily (Red Book, 2012)

Pneumonia, community-acquired; Group A Streptococcus, mild infection or step-down therapy: Oral: Infants ≥3 months, Children, and Adolescents: 50-75 mg/kg/day in 3-4 divided doses (Bradley, 2011); maximum daily dose: 2000 mg/day

Special Populations

  • Pregnancy Rating:
  • Lactation:
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:
  • Mechanism of Action:

See Also

Source

  1. ↑ Shulman ST, Bisno AL, Clegg HW, et al; Infectious Diseases Society of America. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis, 2012, 55(10):e86-102. PubMed 22965026
  2. ↑ Osmon DR, Berbari EF, Berendt AR, et al, “Diagnosis and Management of Prosthetic Joint Infection: Clinical Practice Guideline by the Infectious Diseases Society of America,” Clin Infect Dis, 2013, 56(1):e1-25. PubMed 23223583
  3. ↑ Gerber, 2009; Shulman, 2012; WHO, 2004
  4. ↑ Shulman, 2012
  5. ↑ 4.Gerber MA, Baltimore RS, Eaton CB, et al, "Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute Streptococcal pharyngitis: A Scientific Statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: Endorsed by the American Academy of Pediatrics," Circulation, 2009, 119(11):1541-51. PubMed 19246689
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