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Phcnoxymethylpenicillin is indicated in the treatment of mild to moderately severe infections due to microorganisms whose susceptibility to penicillin G is within the range of serum levels common to this particular dosage form. Therapy should be guided by bacteriologic studies (including susceptibility tests) and by clinical response.
NOTE: Severe pneumonia, empyema, bacteremia, pericarditis, meningitis, and arthritis should not be treated with Phenoxymethylpenicillin during the acute stage. Phenoxymelhylpenicillin is active mainly to the followings: Streptococcal Infections (without bacteremia); Pneumococcal Infections; Staphylococcal Infections Susceptible to Penicillin G; Fusospirochetosis (Vincent’s Gingivitis and Pharyngitis); Medical Conditions in Which Oral Penicillin Therapy Is Indicated as Prophylaxis.
A previous hypersensitivity reaction to any penicillin is a contraindication.
Dosage and administration:
The usual dosage recommendations for adults and children 12 years and over are as follows: Streptococcal Infections: Mild to moderately severe infections of the upper respiratory tract, including scarlet fever and mild erysipelas; 200,000 to 500,000 units every 6 to 8 hours for 10 days. Pneumococcal Infections: Mild to moderately severe infections of the respiratory tract, including otitis media: 400,000 to 500,000 units every 6 hours until the patient has been afebrile for at least 2 days.
Staphylococcal Infections: Mild infections of skin and soft tissue (culture and susceptibility tests should be performed): 400,000 to 500,000 units every 6 to 8 hours. Fusospirochetosis (Vincent’s Infection) of the Oropharynx: Mild to moderately severe infections: 400,000 to 500,000 units every 6 to 8 hours.
Prophylaxis in the Following Conditions: To prevent recurrence following rheumatic fever and/or chorea: 200,000 to 250,000 units twice daily on a continuing basis.
Warnings and precautions:
Serious anaphylactic reactions require immediate emergency treatment with epinephrine. Oxygen, intravenous steroids, and airway management, including intubation, should also be administrated as indicated.
Pseudomembranous colitis has been reported with nearly all antibacterial agents including penicillins, and may range in severity from mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents.
Penicillin should be used with caution in individuals with histories of significant allergies and/or asthma.
The oral route of administration should not be relied upon in patients with severe illness or with nausea, vomiting, gastric dilatation, cardiospasm, or intestinal hypermotility. Occasional patients will not absorb therapeutic amounts of orally administered penicillin.
In streptococcal infections, therapy must be sufficient to eliminate the organism (a minimum of 10 days); otherwise, the sequelae of streptococcal disease may occur. Cultures should be taken following completion of treatment to determine whether streptococci have been eradicated.
Prolonged use of antibiotics may promote the overgrowth of nonsusceptible organisms, including fungi.
If superinfection occurs, appropriate measures should be taken