Penicillin vk 500 mg tablet uses: Penicillin V Potassium: MedlinePlus Drug Information

17.09.202318.07.2023 by alexxlab

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Penicillin V | Side Effects, Dosage, Uses, and More

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Medically reviewed by University of Illinois — By University of Illinois — Updated on November 20, 2018

Highlights for penicillin V

Penicillin V oral tablet is only available as a generic drug.
Penicillin V also comes as an oral solution.
Penicillin V oral tablet is used to treat certain infections caused by bacteria. It won’t work for infections caused by viruses, such as the common cold.

Penicillin V is a prescription drug that comes as an oral tablet and an oral solution.

Penicillin V oral tablet is only available as a generic drug.

Why it’s used

Penicillin V oral tablet is used to treat certain infections caused by bacteria. It won’t work to treat infections caused by viruses, such as the common cold. Bacterial infections this drug is used to treat include:

streptococcal upper respiratory tract infections, scarlet fever, and erysipelas infections
pneumococcal upper respiratory infections
staphylococcal skin and soft tissue infections
fusospirochetosis (infection of the oropharynx or middle part of the throat)
prevention of rheumatic fever and chorea

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

How it works

Penicillin V belongs to a class of drugs called antibiotics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Penicillin V works by stopping the bacteria from multiplying. This kills off the bacteria that are causing your infection.

Penicillin V oral tablet doesn’t cause drowsiness. However, it may cause other side effects.

More common side effects

The more common side effects of penicillin V can include:

nausea
vomiting
stomach upset
diarrhea
black hairy tongue

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Allergic reaction. Symptoms can include:
- skin rash with or without blisters
- flu-like symptoms, such as a fever, feeling ill, or joint pain
- swelling of your throat, tongue, or mouth
Diarrhea. Symptoms include:
- bloody or watery diarrhea with or without stomach cramps and a fever

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Penicillin V oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help prevent interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This dosage information is for penicillin V oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

your age
the condition being treated
the severity of your condition
other medical conditions you have
how you react to the first dose

Forms and strengths

Generic: Penicillin V

Form: Oral tablet
Strengths: 250 mg, 500 mg

Dosage for streptococcal infection

Adult dosage (ages 18 years and older)

Typical dosage: 125–250 mg taken every 6–8 hours for 10 days.

Child dosage (ages 12–17 years)

Typical dosage: 125–250 mg taken every 6–8 hours for 10 days.

Child dosage (ages 0–11 years)

It hasn’t been confirmed that this drug is safe and effective for use in people younger than 12 years.

Dosage for pneumococcal upper respiratory infection

Adult dosage (ages 18 years and older)

Typical dosage: 250–500 mg taken every 6 hours until you no longer have a fever for at least 2 days.

Child dosage (ages 12–17 years)

Typical dosage: 250–500 mg taken every 6 hours until you no longer have a fever for at least 2 days.

Child dosage (ages 0–11 years)

It hasn’t been confirmed that this drug is safe and effective for use in people younger than 12 years.

Dosage for staphylococcal skin or soft tissue infection

Adult dosage (ages 18 years and older)

Typical dosage: 250–500 mg taken every 6–8 hours.

Child dosage (ages 12–17 years)

Typical dosage: 250–500 mg taken every 6–8 hours.

Child dosage (ages 0–11 years)

It hasn’t been confirmed that this drug is safe and effective for use in people younger than 12 years.

Dosage for prevention of rheumatic fever or chorea or both

Adult dosage (ages 18 years and older)

Typical dosage: 125–250 mg taken two times per day.

Child dosage (ages 12–17 years)

Typical dosage: 125–250 mg taken two times per day.

Child dosage (ages 0–11 years)

It hasn’t been confirmed that this drug is safe and effective for use in people younger than 12 years.

Dosage for fusospirochetosis (oropharynx infection)

Adult dosage (ages 18 years and older)

Typical dosage: 250–500 mg taken every 6–8 hours.

Child dosage (ages 12–17 years)

Typical dosage: 250–500 mg taken every 6–8 hours.

Child dosage (ages 0–11 years)

It hasn’t been confirmed that this drug is safe and effective for use in people younger than 12 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Penicillin V oral tablet is used for short-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: Your infection may not get better or may get worse. Even if you’re starting to feel better, you should still finish all of your medication.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of this drug in your body. Symptoms of an overdose of this drug can include:

Diarrhea
Nausea
Oral infection. Symptoms can include:
- creamy white lesions that look like cottage cheese
- cotton mouth (dry mouth)
Vomiting
Blackened tongue

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: Your symptoms and your infection should get better.

As with all medications, the costs of penicillin V can vary.

Keep these considerations in mind if your doctor prescribes penicillin V oral tablet for you.

General

Do not take this drug with food. Take it on an empty stomach, at least 1 hour before eating or 2 hours after eating.

You can cut or crush the tablet.

Storage

Store this drug at room temperature. Keep it between 68°F and 77°F (15°C and 30°C).
Keep the container tightly closed.
Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
Don’t worry about airport X-ray machines. They can’t hurt your medication.
You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor may do blood tests to check how well your kidneys are working. If your kidneys aren’t working well, your doctor may lower your dose of this drug.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Serious allergic reaction warning: This drug can cause a severe allergic reaction. Symptoms include a skin rash with or without blisters, flu-like symptoms (such as a fever, feeling ill, or joint pain), or swelling of your throat, tongue, or mouth. If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room. Don’t take this drug again if you’ve ever had an allergic reaction to it.
Severe diarrhea warning: This drug may cause diarrhea during and after your treatment with it. This diarrhea can be caused by an infection in your intestine called Clostridium difficile. Call your doctor right away if you have bloody or watery diarrhea with or without stomach cramps and a fever while you’re taking this drug.
Prescription completion warning: It’s important you finish all of your penicillin V prescription even if you’re feeling better. If you skip doses or don’t complete the full course of treatment, this drug won’t work as well. Also, the bacteria causing your infection may become resistant to treatment. Resistance means that it won’t respond to penicillin V or other antibiotics in the future.

Allergy warning

Penicillin V can cause a severe allergic reaction. Symptoms can include:

skin rash with or without blisters
flu-like symptoms, such as a fever, feeling ill, or joint pain
swelling of your throat, tongue, or mouth

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it or any other type of penicillin. Taking it again could be fatal (cause death).

If you have severe allergies, you have a higher risk of developing a severe allergic reaction to penicillin. This type of allergic reaction is called anaphylaxis. Symptoms can include throat swelling, trouble swallowing, wheezing, and trouble breathing.

Warnings for people with certain health conditions

For people with asthma: If you have asthma, you have a higher risk of developing a severe allergic reaction to penicillin. This type of allergic reaction is called anaphylaxis. Symptoms can include throat swelling, trouble swallowing, wheezing, and trouble breathing.

For people with kidney problems: If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of penicillin V in your body and cause more side effects.

Warnings for other groups

For pregnant women: The Food and Drug Administration (FDA) hasn’t assigned a pregnancy category to penicillin V. It is not yet known if penicillin V is safe and effective for use in pregnant women. Tell your doctor if you’re pregnant or plan to become pregnant. Penicillin V should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

For women who are breastfeeding: Penicillin V may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

For children: This drug hasn’t been studied in children. It shouldn’t be used in people younger than 12 years of age.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Last medically reviewed on May 21, 2018

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Penicillin V potassium – penicillin v potassium tablet, film coated. (2017).
dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cfc0df21-fb6f-447d-96f6-f851732f9e2f
Penicillin V potassium – penicillin v potassium tablet; Penicillin V potassium- penicillin V potassium for solution. (2014).
dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d6417642-66c5-48b5-86bf-ffb87c4250ac

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Nov 20, 2018

Written By

University of Illinois-Chicago

Edited By

Frank Crooks

May 21, 2018

Medically Reviewed By

University of Illinois-Chicago

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Medically reviewed by University of Illinois — By University of Illinois — Updated on November 20, 2018

Penicillin VK – St. Jude Children’s Research Hospital

What is penicillin VK?

Penicillin VK (also called Pen-Vee K^®, V-Cillin K^®, or Veetids^®) is used to prevent or treat infections. It is available in 250-mg and 500-mg tablets and a liquid suspension. All are taken by mouth.

How to give and store penicillin VK

Take penicillin VK on an empty stomach if possible.
Shake the oral liquid well before you take it. Use an oral syringe or medicine cup to be sure you are taking the correct amount.
Store the liquid in the refrigerator. Discard it after 14 days or when the date on the label expires.

Possible side effects of penicillin VK

Nausea, vomiting
Diarrhea
Rash
Black “hairy” tongue
Loss of appetite
Stomach pain
Allergic reaction with these symptoms: rash, hives, itching, chills, fever, short of breath, muscle aches, swelling of face or neck, headache, tight feeling in throat, and cough

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse.

In case of a severe side effect or reaction, call the doctor, nurse, or pharmacist at 595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 once the call is connected.

Special instructions for penicillin VK

Tell your doctor before taking penicillin VK if you have had an allergic reaction to any other penicillin. If you have any allergic symptoms (listed on page 1) or you have severe or watery diarrhea, tell your doctor right away.
If penicillin causes stomach upset on an empty stomach, you may take it with food.
Finish all doses of this medicine as instructed by your doctor, even if you think your condition is better. Do not stop taking this medicine unless your doctor tells you to do so.
Do not take probenecid or methotrexate while you are taking penicillin VK without telling your doctor. Probenecid may increase the level of penicillin VK in your body. Penicillin VK may increase the level of methotrexate in your body.
While taking penicillin, birth control medicines that contain estrogen might not be effective. Use a second birth control method for at least one (1) month after taking penicillin VK.
Penicillin VK may cause a false-positive urine test result when checking your urine for sugar (glucose) levels.

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

تنبيه: إذا كنت تتحدث باللغة العربية فيمكنك الاستعانة بخدمات المساعدة اللغوية المتوفرة لك مجانا. .يرجى الاتصال بالرقم. 5833-278-866-1 (الهاتف النصي: 1040-595-901-1).

V-Penicillin Slovakofarm – instructions for use, doses, side effects, reviews of the drug:

0.002 ‰

Analogs

All forms of release, dosages, registration certificates, drug manufacturers, drug characteristics

Description of the drug Slovakopharm V-Penicillin (tablets, 250 mg) based on the official instructions, approved by the manufacturer in 2000

Approval date: 07/31/2000

Content

Active substance
ATX
Pharmacological group
Nosological classification (ICD-10)
Composition and form of release
pharmachologic effect
Indications
Contraindications
Use during pregnancy and lactation
Dosage and administration
Side effects
Interaction
Storage conditions
Best before date
Reviews

Active ingredient

Phenoxymethylpenicillin* (Phenoxymethylpenicillin*)

ATX

J01CE02 Phenoxymethylpenicillin

Pharmacological group

Penicillins

Nosological classification (ICD-10)

ICD-10 code list

Composition and formulation

1 tablet contains phenoxymethylpenicillin (in the form of potassium salt) 250 or 500 mg, 10 pcs in a blister . ; in a box of 3 blisters, or in glass bottles of 30 pieces, in a box 1 bottle.

Pharmacological action

Pharmacological action –

antibacterial , germicidal .

Indications

Infections caused by susceptible microorganisms (cocci, tetanus and anthrax bacilli, actinomycetes, clostridia, etc.).

Contraindications

Hypersensitivity to beta-lactam antibiotics.

Use in pregnancy and lactation

Not teratogenic.

Dosage and Administration

Information for healthcare professionals only.
Are you a healthcare professional?

By mouth, do not chew. Adults – 500 mg (children aged 5-12 years – 250 mg) 4-6 times a day for at least 5-7 days.

Side effects

Allergic reactions (skin rashes, urticaria, fever, eosinophilia, arthralgia, angioedema, anaphylactic shock). When prescribing large doses – bleeding, hyperkalemia. Very high doses of the drug cause CNS disorders, especially in children, elderly patients and on the background of renal failure.

Interactions

Information for healthcare professionals only.
Are you a healthcare professional?

Sulfonamides and bacteriostatic antibiotics (tetracyclines, chloramphenicol, etc.) reduce, aminoglycosides increase efficiency. Excretion by the kidneys is slowed down by probenecid, phenylbutazone, salicylates, indomethacin. Reduces the effect of hormonal contraceptives.

Storage conditions

At a temperature of 15–25 °C.

Keep out of reach of children.

Expiry date

5 years.

Do not use after the expiry date which is stated on the pack.

Update date: 04/23/2019

Reviews

Read all reviews and leave your own.

Information for healthcare professionals only.
Are you a healthcare professional?

Inhibitor-protected penicillins in the treatment of acute bacterial rhinosinusitis | Svistushkin V.M., Slavsky A.N., Kirdeeva A.I.

Upper respiratory tract infection (URT) is an inflammatory process of the respiratory tract from the nasal mucosa to the tracheobronchial tree. Most URT infections are caused by viruses. Therefore, treatment with the use of antibacterial drugs is quite limited, and their appointment is impractical. The appointment of antibiotics, if necessary, should be strictly individual in each case, and first of all, the risk-benefit ratio for the patient should be assessed.

Acute rhinosinusitis (ARS) is a fairly common complication of acute respiratory viral infection (ARVI). ARS is an inflammation of the nasal mucosa and at least one of the paranasal sinuses (SNPs). This condition is one of the ten most common diseases in the outpatient practice of an internist. Studies using computed tomography have shown that in ARVI, 87% of patients develop rhinosinusitis, which should be regarded as viral. In 1–2% of cases, a viral infection is complicated by the development of bacterial ARS (ABRS) [4, 7, 20].

ABRS is a fairly common disease with a constant trend towards an increase in the number of cases. For example, in the United States in recent years, there have been approximately 25 million medical visits per year for ARS [24]. In Russia, this problem is further complicated by the fact that from year to year an increasing number of patients require inpatient treatment. Moreover, the proportion of patients hospitalized for SNPs increases annually by 1.5–2% [5, 13].

The classification of ABRS is based on the duration, frequency, and severity of symptoms. The most successful, in our opinion, is the classification proposed by a special commission of the American Academy of Otolaryngology Head and Neck Surgery (Table 1).

According to the severity of the current, there are:

1. Lung: nasal congestion, mucous or mucopurulent discharge from the nose and / or into the oropharynx, fever up to 37.5 ° C, headache, weakness, hyposmia; on the radiograph of the paranasal sinuses – the thickness of the mucous membrane is less than 6 mm.

2. Moderate: nasal congestion, purulent discharge from the nose and / or into the oropharynx, body temperature above 37.5 ° C, pain and tenderness on palpation in the projection of the sinus, headache, hyposmia, malaise, there may be radiating pain in the teeth, ears ; on the radiograph of the SNP of the sinuses, the thickening of the mucous membrane is more than 6 mm, complete darkening or the level of fluid in the 1st or 2nd sinuses.

3. Severe: nasal congestion, often copious purulent discharge from the nose and / or into the oropharynx (but there may be a complete absence of them), body temperature above 38 ° C, severe pain on palpation in the projection of the sinus, headache, anosmia, severe weakness; on the radiograph of the SNP of the sinuses, complete blackout or fluid level in more than 2 sinuses. Blood test: leukocytosis, formula shift to the left, increased ESR. The presence of orbital, intracranial complications or suspicion of them. A serious complication is cavernous sinus thrombosis, mortality in which reaches 30% and does not depend on the adequacy of antibiotic therapy [22].

If we talk about the etiology, then the spectrum of pathogens of acute viral rhinosinusitis practically does not differ from the pathogens of acute respiratory viral infections (rhinovirus, adenovirus, RS virus, parainfluenza, etc.). With regard to the microbial landscape, the most common causative agents of ABRS are Streptococcus pneumoniae and Haemophilus influenzae [4, 12, 25]. In the pathogenesis of ABRS, a large role is given to damage to the ciliated epithelium of the SNP due to the cytotoxic effect of viruses, which, as a rule, leads to disruption of the functioning of the cilia of epithelial cells due to desquamation of the surface layers of the nasal mucosa. As a result of these pathological changes, mucociliary clearance is inhibited, which in turn creates favorable conditions for secondary bacterial infection with the formation of purulent exudate [25].

The main goals of ARS treatment are:

reduction in the duration of illness;
pathogen eradication;
prevention of complications;
relief of clinical symptoms.

From this perspective, antibiotic therapy is considered the key treatment for ABRS. But it is well known that about 2/3 of patients with ABRS recover without antibiotic treatment [18]. It is very important to differentiate between ABRS and ARS of viral etiology before starting treatment. This will determine the need for antibiotic therapy, as well as the advisability of prescribing narrow-spectrum antibiotics.

Antibiotic therapy is indicated for patients with a disease duration of more than 7 days and 2 or more clinical criteria for ABRS (purulent discharge from the nasal passages, pain in the area of the teeth of the upper jaw or facial pain, especially unilateral; unilateral tenderness on palpation in the projection of the maxillary sinus or worsening symptoms after initial improvement) or with severe disease [3, 11, 16, 18, 23].

Before moving on to treatment protocols, I would like to dwell on the main mechanisms of action of first-line antibacterial drugs – penicillin drugs [1, 2, 4, 12]. It is difficult to overestimate the role of penicillin in the treatment of infectious diseases. The history of penicillin began in the 19th century, when the Italian physician B. Gozio discovered the world’s first antibiotic. Most likely, it was penicillin, which, however, did not receive practical use and was forgotten. At 19In 28, the English bacteriologist A. Fleming quite by accident came to the conclusion that ordinary mold synthesizes a substance that destroys bacteria, and called the isolated substance penicillin. But the discovery of the scientist did not arouse interest among doctors. Only in 1938, Oxford University scientists G. Flory and E. Cheyne identified a pure form of penicillin. During the Second World War, the production of this antibiotic began on a large scale. And in 1945, Fleming, Flory and Cheyne received the Nobel Prize for their discovery. In the Soviet Union, the release of penicillin was also established during the Great Patriotic War. At 1944, the first batches of it were delivered to hospitals and to the front. Penicillin has become an indispensable medicine and has saved the lives of many people.

Penicillins are the first natural antibiotics. They belong to the group of β-lactams along with cephalosporins, carbapenems and monobactams. This class of antibiotics occupies a leading position in the treatment of most infections. Currently, this group includes more than 10 antibiotics, which, depending on the sources of production, structural features and antimicrobial activity, are divided into several subgroups: natural, semi-synthetic, among which are antistaphylococcal (oxacillin), extended spectrum (aminopenicillins), antipseudomonal (carboxypenicillins, ureidopenicillins), inhibitor-protected, combined (ampicillin + oxacillin).

The common properties of all drugs in this group are bactericidal action, low toxicity, predominant excretion through the kidneys, a wide range of dosages, the presence of cross-allergy between penicillins, cephalosporins and carbapenems. β-lactams disrupt the synthesis of peptidoglycan, the main component of the bacterial cell wall, thus exerting a bactericidal effect.

Benzylpenicillin is the first natural antibiotic. Despite being used for more than 60 years, it continues to be a significant drug. Natural penicillins are active against gram-positive bacteria: Staphylococcus, Bacillus, Enterococcus, Listeria, Erysipelothrix, Corynebacterium spp. Of the gram-negative bacteria, Neisseria, Pasteurella multocida, Haemophilus ducreyi are sensitive to natural penicillins. Most anaerobes and spirochetes are also sensitive to natural penicillins. The exception is bacteroids, including Bacteroides fragilis. In staphylococci, natural resistance associated with the production of β-lactamase and penicillin-binding protein is increasingly common, therefore, these drugs are not used to treat staphylococcal infections.

The advantages of natural penicillins are bactericidal activity against a number of clinically significant antibiotics, low toxicity and low cost. But in addition to the acquired resistance of staphylococci, pneumococci, gonococci, bacteroids, there is a high allergenicity, including cross, with all penicillins. Currently, natural penicillins are used for empirical therapy of infections. These drugs are used to treat tonsillopharyngitis and syphilis of the upper respiratory tract, erysipelas, scarlet fever and rheumatism.

To overcome the resistance of microorganisms associated with the production of β-lactamases, inhibitors of these enzymes were developed: clavulanic acid, sulbactam and tazobactam, which are involved in the creation of inhibitor-protected aminopenicillins. The antimicrobial spectrum of these drugs is extended for such gram-negative bacteria as Klebsiella, Proteus vulgaris, bacteroids, as well as microflora with acquired resistance, namely β-hemolytic staphylococci, gonococci, Moraxella catarrhalis, Haemophilus influenzae. Thus, as a result of the combination of penicillins with β-lactamase inhibitors, the natural activity of penicillins against these microorganisms is restored.

Aminopenicillins belong to the group of penicillins with an extended spectrum of activity and include ampicillin and amoxicillin. Aminopenicillins, as well as their inhibitor-protected derivatives, are the drugs of choice for the treatment of bacterial infections of the upper respiratory tract (acute rhinosinusitis, acute tonsillopharyngitis), as well as exacerbations of chronic infections (chronic tracheobronchitis, laryngitis, exacerbations of chronic rhinosinusitis, otitis media). Drugs of this group are prescribed for mild and uncomplicated infections, inhibitor-protected derivatives – for severe forms of infection, as well as with a high prevalence of β-lactamase-producing microorganisms.

Unfortunately, microorganisms gradually acquire the ability to overcome the protection inherent in the structure of the antimicrobial drug during its creation. Moreover, this is achieved not only through the formation of new resistance mechanisms, but also through the production of new types of β-lactamases. This process is progressing: if in 1900 14 types of β-lactamases were described, now their number exceeds 300. A striking example of the consequences of such aggression is the almost complete defenselessness of III-generation cephalosporins against β-lactamase mutants of a wide range of Gram-negative bacteria. From this point of view, the protective effect of β-lactamase inhibitors, which prolong the “clinical life” of a number of useful, but initially unprotected antibiotics, seems more predictable.

Interestingly, β-lactamase inhibitors potentiate the action of penicillins not only due to the blockade of enzymes, but also due to the anti-inoculation effect, enhancing the bactericidal properties of polymorphonuclear neutrophils, as well as a kind of “post-β-lactamazo inhibitory” effect. The latter differs from the known post-antibiotic action of antibiotics and persists against some microorganisms, such as Haemophilus Influenzae, for up to 5 hours or more [1, 2, 15, 17].

Nevertheless, amino-protected penicillins are successfully used in ENT practice and are first-line drugs in the treatment of URT infection. To optimize pharmacotherapy, not only the exact choice of the drug is necessary, but also its correct use, dose, route of administration, which largely determines the patient’s compliance.

An antibiotic from the penicillin group, Flemoklav Solutab, in the form of dispersible tablets, which is one of the new dosage forms of antibacterial drugs, has proven itself well in the treatment of sinusitis. The advantages of this form are favorable pharmacokinetic properties, which implies high bioavailability, as well as a uniform increase in the concentration of the active substance in the blood. It should be emphasized that this form causes dyspepsia to the least extent due to the high degree of absorption and limited effect on the intestinal microflora. And the possibility of using the form in the form of a solution allows it to be used in children, including newborns, patients with difficulty swallowing.

In Russia, several antibiotics are registered in the form of Solutab dispersible tablets: amoxicillin (Flemoxin Solutab), amoxicillin / clavulanate (Flemoclav Solutab), doxycycline monohydrate (Unidox Solutab), josamycin (Vilprofen Solutab, cefixime (Supraks Solutab). Amoxicillin in the form of dispersible tablets Solutab has greater bioavailability, reaching a concentration in the blood close to the concentration when using parenteral forms.Due to the low residual concentrations in the intestine, such unpleasant side effects as dyspepsia, diarrhea, which are quite common when using penicillins, are much less common. clavulanate has all the above advantages, and also creates stable plasma concentrations of clavulanic acid, which provides a predictable therapeutic effect, reduces the risk of adverse drug reactions [15, 17].

As for treatment protocols, for mild sinusitis, amoxicillin can be prescribed orally at 0.5–1 g 3 times a day; in case of moderate or exacerbation of chronic sinusitis, Flemoklav Solutab (amoxicillin / clavulanate) orally at 0.625 g 3 r./day or 1.0 g 2 r./day should be prescribed as the starting antibiotic therapy, case of penicillin-resistant pneumococci and β-lactamase-producing strains of Haemophilus influenzae. The cephalosporin drug cefixime (at a dose of 400 mg 1 r./day) has proven itself well.

According to a number of authors, in most cases, amoxicillin is an adequate treatment for rhinosinusitis, but if previous therapy is ineffective, pathology of the frontal, sphenoidal sinus, as well as in children, the use of inhibitor-protected penicillins is required [18, 21, 23].

In addition to amoxicillin and cephalosporin, modern macrolides can be used in the treatment of ABRS, such as josamycin (orally 1.0 g 2 times a day), azithromycin (orally 500 mg 1 times a day, 3 days), clarithromycin (orally 0, 25–0.5 g 2 r./day or 0.5 g 1 r./day), roxithromycin (inside 0.15 g 2 r./day or 0.3 g 1 r./day, 10–12 days). In terms of clinical efficacy, macrolides are not much inferior to first-line antibiotics. Josamycin is a 16-membered macrolide, which is characterized by activity against strains of gram-positive microorganisms resistant to 14- and 15-membered macrolides (azithromycin, clarithromycin, erythromycin, roxithromycin). Macrolides can be the drugs of choice either in case of intolerance to aminopenicillins and cephalosporins, or in the presence of data on the chronic course of the process in the SNP (polyposis-purulent, etc.). In this case, the appointment at the first stage is rational due to the characteristics of the microflora in a chronic process, as well as the favorable effect of macrolides on polyposis tissue [8, 10, 11, 15, 18, 21].

In case of ineffectiveness of the first course of antibiotic therapy, fluoroquinolones are currently used: levofloxacin (0.5 g 1 r./day for 5–10 days), moxifloxacin (0.4 g 1 r./day, 5–10 days), sparfloxacin (0 .4 g 1 rub/day for 5–10 days). It is on the “respiratory” fluoroquinolones (levofloxacin, moxifloxacin) that great hopes have recently been placed in the treatment of sinusitis caused by penicillin-resistant pneumococci. The activity of these drugs also extends to penicillin-resistant strains of Streptococcus pneumoniae, β-lactamase-producing strains of Haemophilus influenzae, Moraxella catarrhalis, as well as to atypical and anaerobic microorganisms.

The criterion for the rationality of the prescribed antibiotic therapy is the assessment of the patient’s condition 72 hours after the start of treatment. The positive dynamics of the patient’s condition suggests the continuation of starting antibiotic therapy. In the absence of such dynamics, after 72 hours, the antibiotic should be changed. In the treatment of sinusitis, in most cases, priority remains with monotherapy. The appointment of 2 or more antibiotics is justified in case of severe sinusitis or the presence or formation of complications [5, 14].

The duration of treatment depends on the drug chosen and the severity of the sinusitis. The course of treatment can be from 7 to 14 days. It is important to completely stop the inflammatory process in the SNP, therefore, with the goal of complete eradication of the pathogen, one should focus on the treatment period of 7-10 days. A significant role in the pathogenesis of ABRS is played by edema of the nasal mucosa and obstruction of the fistulas of the natural openings of the SNP, therefore, vasoconstrictor drugs are of great importance: xylometazoline, oxymetazoline, phenylephrine, etc. Topical glucocorticosteroids have relatively recently entered the arsenal of drugs for the treatment of ARS. Their use helps to reduce the secretion of the glands of the mucous membrane and tissue edema and, as a result, improve nasal breathing (mometasone furoate nasal spray, 100 μg 2 times a day) [7, 12].

Penicillin vk 500 mg tablet uses: Penicillin V Potassium: MedlinePlus Drug Information

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Inhibitor-protected penicillins in the treatment of acute bacterial rhinosinusitis | Svistushkin V.M., Slavsky A.N., Kirdeeva A.I.

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