Difference between revisions of "Penicillin V"

(/* Prosthetic Joint Infection (Offlabel), Chronic SuppressionOsmon 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 D...)
(Pediatric Dosing)
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==Pediatric Dosing==
 
==Pediatric Dosing==
 +
===General===
 +
*'''<12 years'''
 +
**25-50 mg/kg/day divided q6-8 hours
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**Max: 2000 mg/day
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*≥12 years
 +
**125-500mg q6-8 hours
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**Alt: 25-50 mg/kg/day divided q6-8 hours
 +
**Max: 2000 mg/day
 +
 +
===[[Strep Pharyngitis]]===
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*Acute<ref>Gerber, 2009; Shulman, 2012; WHO, 2004</ref>
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**≤27kg: 250mg BID-TID x 10 days
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**>27kg: 500mg BID-TID x 10 days
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*Chronic Carrier ([[Group A streptococci]]
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**50 mg/kg/day divided q6 hours x 10 days + [[rifampin]]
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**Max: 2000 mg/day<ref>Shulman, 2012</ref>
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*Recurrent Rheumatic Fever, prophylaxis
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**250mg BID<ref>Gerber, 2009</ref>
 +
 +
===[[Anthrax]] (Cutaneous)===
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*25-50 mg/kg/day divided BID-QID
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*Max: 500mg per dose (Stevens, 2005)
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 +
 +
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==
 
==Special Populations==

Revision as of 21:17, 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. Gerber, 2009