BNF Penicillin V_ Dosage and Administration Guidelines

BNF Penicillin V: Dosage and Administration Guidelines

Penicillin V, also known as phenoxymethylpenicillin, is an oral antibiotic commonly used to treat a variety of bacterial infections. The British National Formulary (BNF) provides comprehensive guidance on its use, dosage, and administration. Here's an overview of the BNF recommendations for penicillin V:

Indications:

Penicillin V is primarily used for the treatment of mild to moderate infections caused by susceptible organisms, including:

Streptococcal infections (e.g., tonsillitis, pharyngitis)

Skin and soft tissue infections

Dental infections

Prophylaxis of rheumatic fever

Prevention of pneumococcal infection in asplenia or in patients with sickle-cell disease

Adult Dosage:

For oral infection treatment: 500 mg every 6 hours, increased up to 1 g every 6 hours in severe infections

For prophylaxis of recurrent urinary-tract infection: 125-250 mg at night

For prophylaxis of rheumatic fever: 250 mg twice daily

Pediatric Dosage:

For children 1 month to 11 years:

Up to 10 kg: 62.5 mg every 6 hours; increased to 12.5 mg/kg every 6 hours in severe infections

10-20 kg: 125 mg every 6 hours; increased to 12.5 mg/kg every 6 hours in severe infections

Over 20 kg: 250 mg every 6 hours; increased to 12.5 mg/kg every 6 hours in severe infections

For children 12-17 years: Adult dose

Administration:

Penicillin V should be taken on an empty stomach, preferably 30-60 minutes before meals or 2 hours after meals

The tablets can be crushed or the capsules opened and mixed with water if necessary

For liquid formulations, shake well before use

Duration of Treatment:

The duration of treatment varies depending on the condition being treated, typically ranging from 5 to 10 days. However, some conditions may require longer treatment periods.

Contraindications:

Hypersensitivity to penicillins

History of penicillin-associated jaundice or hepatic dysfunction

Cautions:

History of allergy

Renal impairment (dose reduction may be necessary)

Pregnancy and breastfeeding (considered safe but use with caution)

Side Effects:

Common side effects include nausea, vomiting, diarrhea, and skin rashes. Rare but serious side effects can include anaphylaxis and severe cutaneous reactions.

Drug Interactions:

May reduce the efficacy of combined oral contraceptives

May increase the effects of methotrexate

Probenecid increases penicillin concentration in the blood

Monitoring:

Regular monitoring is not usually required for short-term use. However, in prolonged therapy, periodic assessment of organ system functions, including renal, hepatic, and hematopoietic systems, is recommended.

It's important to note that these guidelines are general, and individual patient factors should always be considered. Healthcare professionals should consult the most current BNF for the most up-to-date and detailed information on penicillin V usage and dosing recommendations.