Phenoxymethylpenicillin

Phenoxymethylpenicillin Belongs to the pharmacological class of Beta-Lactam Antibiotics.

Phenoxymethylpenicillin Has been approved to relieve symptoms and also for the treatment and maintenance of Anthrax, Actinomycosis, Bite wound infection, Diphtheria, Gingivitis, Meningococcal Prophylaxis, Pneumococcal Prophylaxis, Prosthetic Joint Infection, Cellulitis, Erysipela, Erysipeloid, Chronic carriage, Fusospirochetosis, Pneumonia, community-acquired & Prophylaxis, Pharyngitis/tonsillitis.

Phenoxymethylpenicillin is well-absorbed after oral administration and reaches peak concentration in the blood within 1-2 hours. The drug is distributed throughout the body, with high concentrations found in the liver, kidneys, and lungs. Phenoxymethylpenicillin is not extensively metabolized in the body and is excreted unchanged in the urine. The half-life of Phenoxymethylpenicillin is short, at approximately 30 minutes, and the drug is typically dosed 2-4 times a day to maintain therapeutic levels in the blood.

The common side effects of using Phenoxymethylpenicillin are Nausea, Vomiting, Diarrhea, Abdominal pain, Skin rash or itching, Headache, Dizziness, and dizziness Yeast infection in the mouth or vagina.

Phenoxymethylpenicillin Is available in the form of Tablets, Capsules, Oral Suspension, Powder for Oral Solutions, and Injections.

Phenoxymethylpenicillin is approved in the U.S., U.K., Germany, Japan, Malaysia, India, and China.

Phenoxymethylpenicillin Belongs to the pharmacological class of Beta-Lactam Antibiotics.

Phenoxymethylpenicillin Is a beta-lactam antibiotic that works by inhibiting the growth of bacterial cell walls. It binds to penicillin-binding proteins (PBPs) in the bacterial cell wall, interfering with the cross-linking of peptidoglycan chains, ultimately leading to cell death.

Phenoxymethylpenicillin has been approved to relieve symptoms and also for the treatment and maintenance of Anthrax, Actinomycosis, Bite wound infection, Diphtheria, Gingivitis, Meningococcal Prophylaxis, Pneumococcal Prophylaxis, Prosthetic Joint Infection, Cellulitis, Erysipelas, Erysipeloid, Chronic carriage, Fusospirochetosis, Pneumonia, community-acquired & Prophylaxis, Pharyngitis/tonsillitis.

The peak concentration of Phenoxymethylpenicillin in the blood occurs 1-2 hours after oral administration. The time it takes for Phenoxymethylpenicillin to reach peak concentration in the blood is 1-2 hours after oral administration.

The onset of action of Phenoxymethylpenicillin varies depending on the infection being treated and the severity of the infection. Generally, improvement in symptoms can be seen within a few days of starting treatment. The half-life of Phenoxymethylpenicillin is approximately 30 minutes. Therefore, the drug is typically dosed 2-4 times a day to maintain therapeutic levels in the blood. The duration of action can vary depending on the infection being treated, but generally, treatment with Phenoxymethylpenicillin is continued for 7-10 days.

Phenoxymethylpenicillin is available in the form of Tablets, Capsules, Oral Suspension, Powder for Oral Solutions, and Injections.

Phenoxymethylpenicillin Can be used in the following treatment:

• Anthrax
• Actinomycosis
• Bite wound infection
• Diphtheria
• Gingivitis
• Meningococcal Prophylaxis
• Pneumococcal Prophylaxis
• Prosthetic Joint Infection\
• Cellulitis
• Erysipelas
• Erysipeloid
• Chronic carriage
• Fusospirochetosis
• Pneumonia, community-acquired & Prophylaxis
• Pharyngitis/tonsillitis

Phenoxymethylpenicillin help to relieve symptoms and also for the treatment and maintenance of Anthrax, Actinomycosis, Bite wound infection, Diphtheria, Gingivitis, Meningococcal Prophylaxis, Pneumococcal Prophylaxis, Prosthetic Joint Infection, Cellulitis, Erysipelas, Erysipeloid, Chronic carriage, Fusospirochetosis, Pneumonia, community-acquired & Prophylaxis, Pharyngitis/tonsillitis.

Phenoxymethylpenicillin is approved for use in the following clinical indications:

• Anthrax
• Actinomycosis
• Bite wound infection
• Diphtheria
• Gingivitis
• Meningococcal Prophylaxis
• Pneumococcal Prophylaxis
• Prosthetic Joint Infection\
• Cellulitis
• Erysipelas
• Erysipeloid
• Chronic carriage
• Fusospirochetosis
• Pneumonia, community-acquired & Prophylaxis
• Pharyngitis/tonsillitis

Actinomycosis (off-label use):Oral: 500 mg to 1 g every 6 hours

Anthrax :

Inhalational exposure (postexposure prophylaxis): Oral: 500 mg every 6 hours

Cutaneous, without systemic involvement, treatment: Oral: 500 mg every 6 hours; duration is 7 to 10 days after naturally acquired infection

Bite wound infection, prophylaxis of high-risk bite or treatment (animal or human bite) (alternative agent) (off-label use): Oral: 500 mg 4 times daily as part of an appropriate combination regimen.

Diphtheria (adjunctive therapy with antitoxin) (off-label use): Oral: 250 mg 4 times daily following parenteral treatment to complete a total treatment course of 14 days

Gingivitis, acute simple, plaque-associated: Oral: 500 mg every 6 to 8 hours in combination with metronidazole for 5 to 7 days

Meningococcal prophylaxis in patients with complement deficiency: Limited data: Oral: 500 mg twice daily in addition to meningococcal vaccination

Pneumococcal prophylaxis in patients at high risk (off-label use): Oral: 250 to 500 mg twice daily; duration varies based on patient-specific factors

Prosthetic joint infection, chronic suppression (off-label use): Oral: 500 mg 2 to 4 times daily

Rat bite fever, uncomplicated infection (off-label use): Oral: 500 mg every 6 hours following parenteral therapy to complete a total treatment course of 14 days

Cellulitis, long-term suppression of recurrent infection (off-label use): Oral: 250 to 500 mg twice daily after completion of treatment

Erysipelas, treatment of mild infection or step-down therapy after initial parenteral therapy: Oral: 500 mg every 6 hours; total duration is five days, with extension to 14 days for the slow response, severe infection, or immunosuppression

Erysipeloid (localized cutaneous Erysipelothrix rhusiopathiae infection), treatment (off-label use): Oral: 500 mg every 6 hours for 5 to 10 days

Streptococcus, group A: Pharyngitis: Oral: 500 mg 2 to 3 times daily for ten days

Secondary prophylaxis in patients with rheumatic fever (prevention of recurrent attacks) : Oral: 250 mg twice daily.

Chronic carriage (off-label use):Oral: 500 mg 4 times daily for ten days; add rifampin for the last four days of therapy

Pediatrics

Anthrax (penicillin-susceptible strains) : Oral: 50 to 75 mg/kg/day in divided doses every 6 to 8 hours

Fusospirochetosis (Vincent infection), mild to moderately severe conditions: Children ≥12 years and Adolescents: Oral: 250 to 500 mg every 6 to 8 hours.

Pneumonia, community-acquired; Group A Streptococcus, mild infection or step-down therapy: Infants, Children, and Adolescents: Oral: 50 to 75 mg/kg/day in divided doses four times daily

Pneumococcal infection prophylaxis, anatomic or functional asplenia (e.g., sickle cell disease): Infants (as soon as SCD is diagnosed or asplenic) and Children <3 years: Oral: 125 mg twice daily.Children ≥3 years: Oral: 250 mg twice daily.

Pneumococcal infection prophylaxis, patients post-hematopoietic cell transplant with chronic graft-versus-host disease or low IgG levels Note: Use only in areas where the incidence of penicillin-resistant Streptococcus pneumoniae is low.

Infants ≥2 months and Children ≤3 years: Oral: 125 mg twice daily

Children >3 years: Oral: 250 mg twice daily.

Adolescents: Oral: 250 to 500 mg twice daily or 500 to 1,000 mg once daily.

Streptococcus, group A:

Pharyngitis/tonsillitis: Limited data available in <12 years of age:

Children ≤27 kg: Oral: 250 mg every 8 to 12 hours for ten days,Children >27 kg and Adolescents: Oral: 500 mg every 8 to 12 hours for ten days.

Phenoxymethylpenicillin is available as follows:

• Tablets: 125mg, 250mg, and 500mg.
• Capsules: 250mg and 500mg.
• Oral Suspension:125mg/5ml, 250mg/5ml, and 500mg/5ml.
• Powder for oral solution: 125mg/5ml and 250mg/5ml.
• Injection: 600mg and 1.2g.

Tablets, Capsules, Oral Suspension, Powder for Oral Solutions, Injections.

• Dosage Adjustments in Pediatric Patients:

Infants and children under 12 years of age: The usual dose for infants and children under 12 years of age is 25 mg/kg body weight per day, divided into two to four doses.

Children over 12 years of age: Children over 12 years of age may be treated with the adult dosage.

Neonates: In neonates, the dose may be reduced to 12.5mg/kg body weight per day, divided into two to four doses.

Renal impairment: Dose adjustments may be necessary for pediatric patients with renal impairment.

There are no specific dietary restrictions while taking Phenoxymethylpenicillin. However, taking this medication on an empty stomach, either one hour before or two hours after meals, is important to ensure maximum absorption. Avoid taking this medication with food or dairy products as they may decrease the absorption of the drug.

In addition, Phenoxymethylpenicillin can disrupt the natural balance of bacteria in the gut, leading to gastrointestinal disturbances such as diarrhea. Consuming probiotics or eating foods rich in probiotics, such as yogurt or fermented foods, may help restore the balance of gut bacteria and reduce the risk of gastrointestinal disturbances.

Phenoxymethylpenicillin may is contraindicated under the following conditions:

• Hypersensitivity: Phenoxymethylpenicillin is contraindicated in patients with a history of hypersensitivity to penicillins or any of the components of the medication. It should also not be administered to patients with a history of severe allergic reactions to cephalosporins, as there may be a risk of cross-allergy.
• Infectious mononucleosis: Phenoxymethylpenicillin is not recommended in patients with infectious mononucleosis, as it may cause a rash.
• Lymphatic leukemia: Phenoxymethylpenicillin should not be used in patients with lymphatic leukemia, as it may cause a rash.
• Severe renal impairment: Phenoxymethylpenicillin is not recommended for use in patients with severe renal impairment, as it may accumulate in the body and cause toxicity.
• Severe hepatic impairment: Phenoxymethylpenicillin is not recommended in patients with severe hepatic impairment, as it may accumulate in the body and cause toxicity.
• Gonorrhea: Phenoxymethylpenicillin is ineffective against gonorrhea and should not be used for this indication.

The physician should closely monitor the patients and keep pharmacovigilance as follows:

Clostridium difficile infection: Phenoxymethylpenicillin has been associated with an increased risk of Clostridium difficile infection (CDI), a potentially life-threatening bacterial infection of the colon. CDI can cause severe diarrhea and inflammation of the colon. Healthcare providers should consider CDI as a possible diagnosis in patients who develop diarrhea while taking Phenoxymethylpenicillin.

Prolongation of the QT interval: Phenoxymethylpenicillin has been associated with prolongation of the QT interval, which can lead to an irregular heartbeat and a potentially life-threatening arrhythmia called Torsades de Pointes. Patients with a history of heart disease, electrolyte imbalances, or taking other medications that prolong the QT interval should be monitored closely while taking Phenoxymethylpenicillin.

Hypersensitivity reactions: Hypersensitivity reactions, including anaphylaxis, have been reported in patients taking Phenoxymethylpenicillin. Healthcare providers should be aware of the signs and symptoms of hypersensitivity reactions and be prepared to treat them promptly.

Methicillin-resistant Staphylococcus aureus (MRSA) infections: Phenoxymethylpenicillin is ineffective against MRSA infections. An alternative antibiotic should be used if a patient has a suspected or confirmed MRSA infection.

Impaired renal function: Patients with poor renal function may require a lower dose of Phenoxymethylpenicillin or a longer dosing interval. Healthcare providers should monitor renal function in these patients and adjust the amount as necessary.

Oral contraceptives: Phenoxymethylpenicillin may decrease the effectiveness of oral contraceptives. Patients taking oral contraceptives should use an additional contraception while taking Phenoxymethylpenicillin.

Gastrointestinal disturbances: Phenoxymethylpenicillin may cause gastrointestinal disorders, including nausea, vomiting, and diarrhea. Patients with a history of gastrointestinal problems should be monitored closely while taking Phenoxymethylpenicillin.

Liver function: Rare cases of liver damage have been reported in patients taking Phenoxymethylpenicillin. Healthcare providers should monitor liver function in patients taking this medication.

Neuromuscular blockade: Phenoxymethylpenicillin may enhance the effect of neuromuscular blocking agents used during surgery, leading to prolonged paralysis. Healthcare providers should monitor patients closely for signs of prolonged paralysis.

Superinfection: The use of antibiotics, including Phenoxymethylpenicillin, may lead to the development of superinfections, which are infections caused by bacteria that are not affected by the antibiotic. Patients should be monitored closely for signs of superinfection, such as fever, new or worsening symptoms, or changes in laboratory values.

There is no specific alcohol warning for Phenoxymethylpenicillin. However, it is generally recommended to avoid consuming alcohol while taking any antibiotic medication as it can affect the drug's effectiveness and increase the risk of side effects. Alcohol consumption may also impair the body's ability to fight infections.

There is limited data available on the use of Phenoxymethylpenicillin during lactation. However, based on the available evidence, Phenoxymethylpenicillin is considered safe to use during breastfeeding.

Pregnancy Category B

Phenoxymethylpenicillin is generally considered safe to use during pregnancy and is often prescribed for treating bacterial infections such as strep throat, tonsillitis, and skin infections. The medication has been widely used for decades and has not been associated with significant harm to the developing fetus. However, as with all medicines, it should be used only if clearly needed and under the guidance of a healthcare provider.

No sufficient scientific evidence is traceable regarding the use and safety of Phenoxymethylpenicillin in concurrent use with any particular food.

The adverse reactions related to Phenoxymethylpenicillin can be categorized as follows:

Common adverse reactions (affecting 1-10% of people taking the medication):

• Gastrointestinal symptoms: These can include nausea, vomiting, diarrhea, and abdominal pain.
• Allergic reactions: In some cases, Phenoxymethylpenicillin can cause an allergic reaction, which can range from mild to severe. Symptoms of an allergic reaction can include hives, itching, swelling, difficulty breathing, and anaphylaxis.
• Skin reactions: Some people may develop a rash or other skin reactions while taking Phenoxymethylpenicillin.
• Superinfection: Phenoxymethylpenicillin can cause an overgrowth of bacteria or fungi not affected by the medication, leading to a secondary infection.

Very Common adverse reactions (affecting more than 10% of people taking the medication):

• None reported.

Rare adverse reactions (affecting less than 0.1% of people taking the medication):

• Liver and kidney problems: Phenoxymethylpenicillin can cause liver or kidney damage in rare cases.
• Blood disorders: In rare cases, Phenoxymethylpenicillin can cause a decrease in white blood cells or platelets, which can lead to an increased risk of infections or bleeding.

The clinically relevant drug interactions of Phenoxymethylpenicillin are briefly summarized here:

• Probenecid: This medication is used to treat gout and may increase the level of phenoxy benzyl penicillin in the blood, which can increase the risk of side effects.
• Methotrexate: Phenoxybenzylpenicillin may increase the level of methotrexate in the blood, which can increase the risk of side effects such as liver damage.
• Warfarin: Phenoxybenzylpenicillin may increase the effect of warfarin, which can increase the risk of bleeding.
• Oral contraceptives: Phenoxybenzylpenicillin may decrease the effectiveness of oral contraceptives, which can increase the risk of pregnancy.
• Tetracyclines: Phenoxybenzylpenicillin may reduce the effectiveness of tetracyclines, another antibiotic type.
• Aminoglycosides: When phenoxy benzyl penicillin is used together with aminoglycosides such as gentamicin, it can increase the risk of kidney damage.
• Methoxyflurane: When phenoxy benzyl penicillin is used together with methoxyflurane, it can increase the risk of kidney damage.
• Anticoagulants: Phenoxybenzylpenicillin can increase the effect of anticoagulant medications, which can increase the risk of bleeding.
• Allopurinol: When phenoxy benzyl penicillin is used together with allopurinol, it can increase the risk of skin rash.

The following are the side effects involving Phenoxymethylpenicillin:

• Fever
• Swelling
• Skin rash
• Hives
• Hypersensitivity reactions
• Headache
• Chills
• Nausea
• Vomiting
• Diarrhea
• Stomach pain

• Pregnancy

Pregnancy Category B

Phenoxymethylpenicillin is generally considered safe to use during pregnancy and is often prescribed for treating bacterial infections such as strep throat, tonsillitis, and skin infections. The medication has been widely used for decades and has not been associated with any significant harm to the developing fetus. However, as with all medications, they should be used only if needed and under the guidance of a healthcare provider.

The United States Food and Drug Administration (FDA) assigns a pregnancy category to medications based on the potential for fetal harm. Phenoxymethylpenicillin is classified as Pregnancy Category B, which means that animal reproduction studies have not shown any fetal risk, but there are no adequate and well-controlled studies in pregnant women. However, based on clinical experience, Phenoxymethylpenicillin is considered safe during pregnancy.

It is important to note that pregnant women may be more susceptible to certain types of infections, and untreated bacterial infections can have serious consequences for both the mother and the developing fetus. Therefore, treating infections in pregnant women with antibiotics when necessary is important. Phenoxymethylpenicillin is one of the antibiotics that may be considered for use during pregnancy, based on the individual case and the healthcare provider's judgment.

Pregnant women should always discuss the risks and benefits of taking Phenoxymethylpenicillin with their healthcare provider before using it.

• Lactation

There is limited data available on the use of Phenoxymethylpenicillin during lactation. However, based on the available evidence, Phenoxymethylpenicillin is considered safe during breastfeeding.

Several studies have investigated the use of penicillin antibiotics during lactation. These studies suggest that penicillin antibiotics are generally safe during breastfeeding and do not pose a significant risk to the nursing infant. Studies have found that only small amounts of the medication are excreted into breast milk and that these levels are unlikely to cause harm to the nursing infant.

While there are no specific studies on using Phenoxymethylpenicillin during lactation, the medication belongs to the penicillin class of antibiotics, which has been extensively studied in lactating women. In addition, the body rapidly breaks down Phenoxymethylpenicillin and does not accumulate in breast milk or the nursing infant.

Based on the available evidence, the American Academy of Pediatrics considers Phenoxymethylpenicillin to be compatible with breastfeeding. The World Health Organization (WHO) also considers penicillin antibiotics to be safe to use during lactation.

In summary, while there are limited studies specifically on the use of Phenoxymethylpenicillin during lactation, the available evidence suggests that it is safe to use during breastfeeding. However, as always, it is essential to consult with a healthcare provider before taking any medication during lactation to evaluate the potential risks and benefits in the specific case.

• Pediatric

Phenoxymethylpenicillin is commonly used to treat bacterial infections in pediatric infants, toddlers, and children. The medication is generally considered safe and effective when used as directed by a healthcare provider.

Phenoxymethylpenicillin belongs to the penicillin class of antibiotics, which has been extensively used in pediatric populations for many years. The medication works by inhibiting the growth of bacteria and is commonly used to treat infections such as strep throat, tonsillitis, and skin infections in children.

Several clinical studies have investigated the use of Phenoxymethylpenicillin in pediatric populations. These studies have found that the medication effectively treats bacterial infections in children and is generally well-tolerated with few side effects. Some children may experience mild side effects such as diarrhea, nausea, or rash, but these side effects are usually not severe and go away independently.

The dosing of Phenoxymethylpenicillin in pediatric populations is based on the child's weight, and healthcare providers will determine the appropriate dosage based on the individual case. In addition, healthcare providers may consider factors such as the severity of the infection and the child's overall health when deciding to prescribe Phenoxymethylpenicillin to a child.

In summary, Phenoxymethylpenicillin is considered safe and effective in treating bacterial infections in pediatric populations. However, as with all medications, it is important to use Phenoxymethylpenicillin only as directed by a healthcare provider and to closely monitor children for any signs of adverse effects. Parents and caregivers should also consult with their healthcare provider before giving any medication to a child.

• Geriatric

Phenoxymethylpenicillin can be used in geriatric populations to treat bacterial infections, but caution may be needed in some cases. Old people, incredibly frail or with multiple medical conditions, may be more susceptible to medication adverse effects, including Phenoxymethylpenicillin.

In general, Phenoxymethylpenicillin is well-tolerated in geriatric populations. However, some elderly patients may have reduced kidney function, affecting how the body processes and eliminates medications. Healthcare providers may need to adjust the dose of Phenoxymethylpenicillin in these cases to reduce the risk of adverse effects.

In addition, elderly patients may be taking multiple medications for various medical conditions, which can increase the risk of drug interactions. Healthcare providers need to review all medications that a geriatric patient is taking before prescribing Phenoxymethylpenicillin to identify any potential drug interactions or contraindications.

Overall, Phenoxymethylpenicillin can be safely used in geriatric populations with appropriate monitoring and dose adjustments as needed. Healthcare providers should carefully evaluate each case and consider the patient's overall health status, medical conditions, and other medications before prescribing Phenoxymethylpenicillin to a geriatric patient.

Physicians should be knowledgeable and vigilant about the treatment and identification of overdosage of Phenoxymethylpenicillin.

An overdose of Phenoxymethylpenicillin can cause symptoms such as nausea, vomiting, stomach pain, diarrhea, and seizures. In case of an overdose, the patient should seek medical attention immediately. Treatment for an overdose may include inducing vomiting or gastric lavage (stomach pumping) and providing supportive care. Hemodialysis is not effective in removing Phenoxymethylpenicillin from the body.

Pharmacodynamics

Phenoxymethylpenicillin is a narrow-spectrum antibiotic that acts by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located on the bacterial cell wall, thereby blocking the transpeptidase reaction required for the final step of peptidoglycan synthesis. This results in inhibiting cell wall biosynthesis and eventual lysis of the bacterial cell.

Phenoxymethylpenicillin is active against gram-positive bacteria such as Streptococcus pneumoniae, Streptococcus pyogenes, and some strains of Staphylococcus aureus. It is also active against gram-negative cocci like Neisseria gonorrhoeae. The antimicrobial effect is time-dependent, and it is essential to maintain a minimum inhibitory concentration (MIC) above the bacterial growth requirement for the duration of therapy.

The pharmacodynamic parameters of Phenoxymethylpenicillin are similar to other beta-lactam antibiotics. Phenoxymethylpenicillin's efficacy depends on factors such as the bacterial susceptibility profile, the site of infection, the host immune response, and the pharmacokinetic properties of the drug. The main pharmacodynamic parameter of interest is when the serum concentration remains above the minimum inhibitory concentration (T>MIC). A T>MIC of at least 50% is necessary for bactericidal activity against the most susceptible bacteria.

In addition, Phenoxymethylpenicillin exhibits a post-antibiotic effect, which means bacterial growth is suppressed even after the antibiotic is no longer present. This is thought to be due to the continued inhibition of bacterial cell wall synthesis even after the body has cleared the antibiotic.

Pharmacokinetics

• Absorption: Phenoxymethylpenicillin is rapidly absorbed from the gastrointestinal tract after oral administration. The absorption is almost complete, and peak plasma concentrations are achieved within 1 to 2 hours after administration.

• Distribution: Phenoxymethylpenicillin is distributed widely throughout the body tissues and fluids, including the skin, respiratory tract, and urinary tract. It is highly protein-bound, with approximately 80% to 90% bound to plasma proteins.

• Metabolism: Phenoxymethylpenicillin is not metabolized in the body, and it is excreted unchanged in the urine.

• Elimination: Phenoxymethylpenicillin is primarily eliminated from the body by renal excretion, with approximately 90% of the administered dose excreted unchanged in the urine within 24 hours. The elimination half-life is approximately 30 minutes to 1 hour.

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