Penicil indications
it is used where prolonged low concentrations of Penicil are required.
This combination is aimed at reducing the pain and discomfort associated with a large intramuscular injection of penicillin.
Penicil description
Penicil (Penicillin G) is narrow spectrum antibiotic used to treat infections caused by susceptible bacteria. It is a natural penicillin antibiotic that is administered intravenously or intramuscularly due to poor oral absorption. Penicillin G may also be used in some cases as prophylaxis against susceptible organisms. Natural penicillins are considered the drugs of choice for several infections caused by susceptible gram positive aerobic organisms, such as Streptococcus pneumoniae, groups A, B, C and G streptococci, nonenterococcal group D streptococci, viridans group streptococci, and non-penicillinase producing staphylococcus. Aminoglycosides may be added for synergy against group B streptococcus (S. agalactiae), S. viridans, and Enterococcus faecalis. The natural penicillins may also be used as first or second line agents against susceptible gram positive aerobic bacilli such as Bacillus anthracis, Corynebacterium diphtheriae, and Erysipelothrix rhusiopathiae. Natural penicillins have limited activity against gram negative organisms; however, they may be used in some cases to treat infections caused by Neisseria meningitidis and Pasteurella. They are not generally used to treat anaerobic infections. Resistance patterns, susceptibility and treatment guidelines vary across regions.
Penicil dosage
IM/IV Adult 0.6-2.4 g daily in 2-4 divided doses. Meningococcal & pneumococcal meningitis 9.6-14.4 g daily (2.4 g 4-6 hrly); up to 18 g daily for meningococcal meningitis. Childn & infant 1 mth-12 yr 100 mg/kg body wt daily in divided doses. Neonate 1-4 wk 75 mg/kg body wt daily in 3 divided doses; 50 mg/kg body wt daily in 2 divided doses. Severe meningococcal meningitis Childn & infant 1 mth-12 yr 180-300 mg daily in 4-6 divided doses. Neonate 1-4 wk 150 mg/kg daily in 3 divided doses; >7 days 100 mg/kg daily in 2 divided doses. Suspected meningococcal infection Adult & childn >10 yr 1.2 g; 1-9 yr 600 mg; <1 yr 300 mg. Intrapartum prophylaxis against group B streptococci infection Initially 3-1.5 g 4 hrly until delivery.
Penicil interactions
Probenecid decreases the renal tubular secretion of amoxicillin. Concurrent use of amoxicillin and probenecid may result in increased and prolonged blood levels of amoxicillin.
Chloramphenicol, macrolides, sulfonamides, and tetracy-clines may interfere with the bactericidal effects of penicillin. This has been demonstrated in vitro; however, the clinical significance of this interaction is not well documented.
Drug/Laboratory Test Interactions: High urine concentrations of ampicillin may result in false-positive reactions when testing for the presence of glucose in urine using CLINITEST®, Benedictís Solution, or Fehlingís Solution. Since this effect may also occur with amoxicillin, it is recommended that glucose tests based on enzymatic glucose oxi-dase reactions (such as CLINISTIX®) be used.
Following administration of ampicillin to pregnant women, a transient decrease in plasma concentration of total conjugated estriol, estriol-glucuronide, conjugated estrone, and estradiol has been noted. This effect may also occur with amoxicillin.
Carcinogenesis, Mutagenesis, Impairment of Fertility:
Long-term studies in animals have not been performed to evaluate carcinogenic potential. Studies to detect mutagenic potential of amoxicillin alone have not been conducted; however, the following information is available from tests on a 4:1 mixture of amoxicillin and potassium clavulanate (AUGMENTIN). AUGMENTIN was non-mutagenic in the Ames bacterial mutation assay, and the yeast gene conversion assay. AUGMENTIN was weakly positive in the mouse lymphoma assay, but the trend toward increased mutation frequencies in this assay occurred at doses that were also associated with decreased cell survival. AUGMENTIN was negative in the mouse micronucleus test, and in the dominant lethal assay in mice. Potassium clavulanate alone was tested in the Ames bacterial mutation assay and in the mouse micronucleus test, and was negative in each of these assays. In a multi-generation reproduction study in rats, no impairment of fertility or other adverse reproductive effects were seen at doses up to 500 mg/kg (approximately 3 times the human dose in mg/m2).
Pregnancy: Teratogenic Effects: Pregnancy Category B. Reproduction studies have been performed in mice and rats at doses up to 10 times the human dose and have revealed no evidence of impaired fertility or harm to the fetus due to amoxicillin. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Labor and Delivery:
Oral ampicillin-class antibiotics are poorly absorbed during labor. Studies in guinea pigs showed that intravenous administration of ampicillin slightly decreased the uterine tone and frequency of contractions but moderately increased the height and duration of contractions. However, it is not known whether use of amoxicillin in humans during labor or delivery has immediate or delayed adverse effects on the fetus, prolongs the duration of labor, or increases the likelihood that forceps delivery or other obstetrical intervention or resuscitation of the newborn will be necessary.
Nursing Mothers: Penicillins have been shown to be excreted in human milk. Penicil use by nursing mothers may lead to sensitization of infants. Caution should be exercised when amoxicillin is administered to a nursing woman.
Pediatric Use: Because of incompletely developed renal function in neonates and young infants, the elimination of amoxicillin may be delayed. Dosing of AMOXIL should be modified in pediatric patients 12 weeks or younger (£3 months). (See DOSAGE AND ADMINISTRATIONñNeonates and infants.)
Penicil side effects
Phenoxymethylpenicillin may produce diarrhoea, nausea and heartburn. Allergic reactions which may include exfoliative dermatitis, other skin rashes, interstitial nephritis and vasculitis, may occur.
A generalised sensitivity reaction with urticaria, fever, joint pains and eosinophilia can develop within a few hours to several weeks after starting treatment. Superinfection by resistant species, such as Pseudomonas or Candida, which do not respond to penicillin therapy may occur. A sore mouth and a black hairy tongue have been reported.
Increases in liver enzyme values have been reported. Care should be taken when high doses are given to patients with renal impairment (because of the risk of neurotoxicity) or congestive heart failure.
Renal and haematological systems should be monitored during prolonged and high dose therapy.
Care should be taken when treating patients with syphilis, as the Jarisch-Herxheimer reaction may occur shortly after starting treatment. This reaction, manifesting as fever, chills, headache and reactions at the site of the lesion, can be dangerous in cardiovascular syphilis or where there is a serious risk of increased local damage such as with optic atrophy.
Haemolytic anaemia and leucopenia, prolongation of bleeding time and defective platelet function have been observed. Convulsions and other signs of toxicity to the CNS may occur particularly in patients with renal failure.
Disturbances of blood electrolytes may follow the administrations of large doses of this medicine.
High doses should be used with caution in patients receiving potassium containing medicines or potassium-sparing diuretics.
Penicil contraindications
Hypersensitivity to Penicil and other penicillins.
Active ingredient matches for Penicil:
Benzylpenicillin in Mexico.
Benzylpenicillin G/Procaine Benzylpenicillin
Benzylpenicillin sodium/Procaine benzylpenicillin in Mexico.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
