Phenoxymethylpenicillin

Phenoxymethylpenicillin is an antibiotic from the category of penicillins.

[1], [2], [3], [4], [5], [6]

Indications Phenoxymethylpenicillinyl

It is used to eliminate infections that occur:

• in the oral cavity (such as periodontitis with actinomycosis, as well as bacterial form of stomatitis );
• inside the respiratory system (bronchitis or pulmonary inflammation);
• in the epidermis and subcutaneous layers (impetigo of a contagious nature, abscesses with phlegmon, and in addition furunculosis, erythema breaker and migratory rash, having erythematous nature).

In addition, the drug is recommended for use in tetanus with botulism, as well as lymphadenitis, gonorrhea with syphilis, anthrax, diphtheria and infectious jaundice.

The medication is used to prevent the recurrence of rheumatoid arthritis, endocarditis of bacterial origin, Sydenham's chorea, glomerular nephritis and rheumatism, and in addition to prevent complications of infectious genesis after surgical procedures.

[7], [8], [9]

Release form

Release of the drug is in the form of lyophilizate or tablets, which are taken orally.

[10], [11], [12]

Pharmacodynamics

The mechanism of drug action is based on the inhibition of the binding of cell membranes.

Phenoxymethylpenicillin has a bactericidal effect on most of the gram-positive microbes (such as staphylococci with streptococci), a small number of gram-negative bacteria (for example, neisseria), and in addition listeria with treponema and corynebacteria.

The drug does not affect the activity of streptococci, which are able to independently produce penicillinase (this is a specific enzyme that can inactivate and break down the antibodies of β-lactam type).

The medication does not affect the life activity of germs-causative agents of amoebiasis, rickettsia, viruses, and also most of the gram-negative bacteria.

The active element of the drug is resistant to acid, but it is destroyed by contact with penicillinase.

[13], [14], [15], [16]

Pharmacokinetics

The drug is resistant to stay inside an acidic environment. Absorption inside the small intestine - approximately 30-60%, synthesis with protein inside the plasma - about 60-80%. The substance circulates for a long time inside the blood, passing through the tissue at low speed. High values of the drug element are found inside the kidneys, and lower indices inside the intestinal walls, liver and epidermis. Therapeutic indices inside the blood of the drug reach after a period of 0.5 hours; they persist for 3-6 hours.

The level of hepatic metabolism of the element is approximately 30-35%. The half-life is about 30-45 minutes. This period is prolonged in the elderly, newborns, as well as those who have kidney failure.

Excretion of the unchanged component is 25%, of metabolic products - 35%. About 30% of drugs are excreted with feces.

[17], [18], [19], [20], [21],

Dosing and administration

You need to take the tablets 60 minutes before meals, drinking them with plain water.

A teenager of 12 years and an adult is assigned the following mode of use: taking 0.5-1 g of LS 3-4 times / day (1 mg of the drug contains 1610 units).

Persons with disorders of renal activity need a medication with a minimum of 12 hours.

The average duration of the treatment cycle is 5-7 days.

During therapy with infections provoked by the action of β-hemolytic streptococcus, the antibacterial treatment course should continue for 3 more days after the normal temperature of the patient has recovered (average duration is 1-2 weeks).

To prevent the development of attacks of Sydenham's chorea or rheumatic symptoms, it is required to take 0.5 g of drugs twice a day.

To exclude the risk of infection after a surgical procedure, it is required to inject 2 g of the drug before it, and then 0.5 g of the substance taken at intervals of 6 hours at intervals of 6 hours.

A suspension made from a soluble powder is used for children. Dosage sizes are calculated in the proportion of 20-50 mg / kg.

[25], [26], [27], [28], [29],

Contraindications

The main contraindications:

• pathologies of infectious nature, having a severe degree of severity;
• presence of hypersensitivity to penicillins with cephalosporins, carbapenem, and other β-lactam antibiotics;
• stomatitis or pharyngitis of aphthous nature;
• diseases affecting the functioning of the digestive system, against which vomiting and diarrheal syndrome are noted.

[22], [23]

Side effects Phenoxymethylpenicillinyl

Medication can lead to the appearance of allergy symptoms (local cutaneous hyperemia, runny nose, conjunctivitis, Quincke edema and urticaria). Occasionally, therapy causes the development of eosinophilia, arthralgia, anaphylaxis, febrile state and serum sickness.

Tablets can cause the appearance of thrombocyto-, leuko- or pancytopenia, as well as agranulocytosis and hemolytic anemia.

Among the violations of the digestive function: cheilitis of the vesicle nature (develops due to the irritating effect of the active element of the drug against the mucous membranes), glossitis with stomatitis, and in addition dyspeptic symptoms (vomiting or diarrheal syndrome, as well as nausea and discomfort sensations in the epigastric zone) and dryness oral mucosa. Also, the appetite worsens, the taste receptors disrupt the function and the pseudomembranous form of enterocolitis develops (occasionally).

Also, therapy can lead to the appearance of vasculitis, pharyngitis or tubulointerstitial nephritis.

[24]

Overdose

Poisoning with Phenoxymethylpenicillin can lead to vomiting, diarrhea, seizures and nausea.

To eliminate the violation, you need to seek medical help from a doctor.

[30]

Interactions with other drugs

The drug reduces the effectiveness of oral contraceptive drugs, and in addition to these drugs that are metabolized with the formation of PABA. Combination with anticoagulants of an indirect form of exposure leads to the development of the opposite effect.

The use of ethinylestradiol significantly increases the likelihood of breakthrough bleeding. The use of allopurinol increases the risk of allergy, manifested in the form of a rash on the epidermis.

Diuretic drugs, phenylbutazone and NSAIDs increase blood levels of the antibiotic, weakening excretory processes inside the renal tubules.

When taken together with laxatives, aminoglycosides, food, glucosamine or antacids, the rate and degree of adsorption of drugs is weakened. The reverse effect is noted when combined with vitamin C.

Synergism of drug effect is recorded when the drug is combined with bactericidal antibiotics (vancomycin with cycloserine, individual cephalosporins and rifampicin).

Antagonistic effect is observed when used together with antibiotics bacteriostatic type (among them macrolides with lincosamides, as well as chloramphenicol with tetracyclines).

[31], [32], [33],

Storage conditions

Phenoxymethylpenicillin is required to be kept out of the reach of children and access to sunlight. Temperature values - no more than 30 ° C.

[34], [35]

Shelf life

Phenoxymethylpenicillin can be used within 48 months from the date of manufacture of the drug.

[36]

Analogues

The analogues of the medication are the agents Vepicombin with Ospen, and also Cliacil with Megacillin plowed.

[37], [38], [39], [40], [41], [42]

Reviews

Phenoxymethylpenicillin receives a large number of positive reviews. It is noted that it works very well in the treatment of various infections, and in addition is tolerated by patients without complications (provided that the treatment scheme and all instructions prescribed by the attending physician are observed).