Penicillin V
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
- Recurrent Rheumatic Fever, prophylaxis
- 250mg BID[5]
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
- ↑ 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
- ↑ 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
- ↑ Gerber, 2009; Shulman, 2012; WHO, 2004
- ↑ Shulman, 2012
- ↑ Gerber, 2009