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Penicillin V Potassium Dosage

Applies to the following strength(s): 250 mg ; 500 mg ; 125 mg/5 mL ; 250 mg/5 mL

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for Bacterial Infection

Mild to moderate infections: 125 to 500 mg orally every 6 to 8 hours

Usual Adult Dose for Streptococcal Infection

Mild to moderate infections of the upper respiratory tract and including scarlet fever and erysipelas: 125 to 250 mg orally every 6 to 8 hours for 10 days

Usual Adult Dose for Upper Respiratory Tract Infection

Mild to moderate streptococcal infections of the upper respiratory tract: 125 to 250 mg orally every 6 to 8 hours for 10 days

Mild to moderate pneumococcal infections of the respiratory tract, including otitis media: 250 to 500 mg orally every 6 hours until the patient has been afebrile for at least 2 days

Usual Adult Dose for Skin or Soft Tissue Infection

Mild staphylococcal infections (penicillin G-sensitive): 250 to 500 mg orally every 6 to 8 hours

Usual Adult Dose for Fusospirochetosis

Mild to moderate infections of the oropharynx: 250 to 500 mg orally every 6 to 8 hours

Usual Adult Dose for Tonsillitis/Pharyngitis

Streptococcal tonsillopharyngitis (primary prevention of rheumatic fever): 500 mg orally 2 to 3 times a day for 10 days

Usual Adult Dose for Rheumatic Fever Prophylaxis

Secondary prevention of rheumatic fever (prevention of recurrence): 250 mg orally twice a day on a continuing basis

The manufacturer recommends 125 to 250 mg orally twice a day on a continuing basis for the prevention of recurrence following rheumatic fever and/or chorea.

For high-risk patients, penicillin G benzathine given every 3 weeks may be more effective and is recommended. Oral penicillin can be used for prevention in lower risk patients whose compliance can be ensured.

Usual Adult Dose for Otitis Media

Mild to moderate pneumococcal infections: 250 to 500 mg orally every 6 hours until the patient has been afebrile for at least 2 days

Usual Adult Dose for Pneumonia

Mild to moderate infections: 250 to 500 mg orally every 6 hours

Usual Adult Dose for Cutaneous Bacillus anthracis

Treatment of mild, uncomplicated cutaneous anthrax (IV therapy not considered necessary): 200 to 500 mg orally 4 times a day

Duration: 5 to 10 days for naturally occurring or endemic exposures to anthrax; therapy should be continued for 60 days if cutaneous anthrax occurred as result of exposure to aerosolized B anthracis spores

Usual Adult Dose for Clostridial Infection

Wound botulism: 250 to 500 mg orally every 6 hours once the patient improves after treatment with aqueous penicillin G and debridement

Usual Adult Dose for Lyme Disease - Erythema Chronicum Migrans

250 to 500 mg orally every 6 hours for 14 to 21 days

Amoxicillin and doxycycline are considered the oral drugs of choice.

Usual Adult Dose for Rat-bite Fever

Mild infection: 500 mg orally every 6 hours
Duration: 10 to 14 days

Usual Pediatric Dose for Bacterial Infection

Mild to moderate infections:
Greater than 1 month to less than 12 years: 25 to 50 mg/kg per day orally in divided doses every 6 to 8 hours
Maximum dose: 3 g/day

12 years or older: 125 to 500 mg orally every 6 to 8 hours

Usual Pediatric Dose for Streptococcal Infection

Mild to moderate infections of the upper respiratory tract and including scarlet fever and erysipelas:
12 years or older: 125 to 250 mg orally every 6 to 8 hours for 10 days

Usual Pediatric Dose for Upper Respiratory Tract Infection

Mild to moderate streptococcal infections of the upper respiratory tract:
12 years or older: 125 to 250 mg orally every 6 to 8 hours for 10 days

Mild to moderate pneumococcal infections of the respiratory tract, including otitis media:
12 years or older: 250 to 500 mg orally every 6 hours until the patient has been afebrile for at least 2 days

Usual Pediatric Dose for Skin or Soft Tissue Infection

Mild staphylococcal infections (penicillin G-sensitive):
12 years or older: 250 to 500 mg orally every 6 to 8 hours

Usual Pediatric Dose for Fusospirochetosis

Mild to moderate infections of the oropharynx:
12 years or older: 250 to 500 mg orally every 6 to 8 hours

Usual Pediatric Dose for Tonsillitis/Pharyngitis

Streptococcal tonsillopharyngitis (primary prevention of rheumatic fever):
Children 27 kg or less: 250 mg orally 2 to 3 times a day
Children greater than 27 kg and adolescents: 500 mg orally 2 to 3 times a day

Duration: 10 days

Usual Pediatric Dose for Rheumatic Fever Prophylaxis

Secondary prevention of rheumatic fever (prevention of recurrence): 250 mg orally twice a day on a continuing basis

The manufacturer recommends 125 to 250 mg orally twice a day on a continuing basis for the prevention of recurrence following rheumatic fever and/or chorea.

For high-risk patients, penicillin G benzathine given every 3 weeks may be more effective and is recommended. Oral penicillin can be used for prevention in lower risk patients whose compliance can be ensured.

Usual Pediatric Dose for Otitis Media

Mild to moderate pneumococcal infections:
12 years or older: 250 to 500 mg orally every 6 hours until the patient has been afebrile for at least 2 days

Usual Pediatric Dose for Pneumonia

Mild to moderate infections:
12 years or older: 250 to 500 mg orally every 6 hours

Usual Pediatric Dose for Cutaneous Bacillus anthracis

Treatment of mild, uncomplicated cutaneous anthrax (IV therapy not considered necessary):
Less than 12 years: 25 to 50 mg/kg/day orally in 2 to 4 divided doses
12 years or older: 200 to 500 mg orally 4 times a day

Duration: 5 to 10 days for naturally occurring or endemic exposures to anthrax; therapy should be continued for 60 days if cutaneous anthrax occurred as result of exposure to aerosolized B anthracis spores

Initial therapy should be IV for young children (i.e., less than 2 years of age) and combination therapy should be considered since it is unknown if infants and young children are at greater risk of systemic dissemination of cutaneous anthrax.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported with antibiotics. The drug should be discontinued immediately at the first appearance of a skin rash or other signs of hypersensitivity. Severe, acute hypersensitivity reactions may require treatment with epinephrine and other resuscitative measures including oxygen, intravenous fluids, antihistamines, corticosteroids, cardiovascular support and airway management as clinically indicated.

Clostridium difficile associated diarrhea (CDAD) has been reported with almost all antibiotics and may potentially be life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea following penicillin therapy. Mild cases generally improve with discontinuation of the drug, while severe cases may require supportive therapy and treatment with an antimicrobial agent effective against C difficile. Hypertoxin producing strains of C difficile cause increased morbidity and mortality; these infections can be resistant to antimicrobial treatment and may necessitate colectomy.

Caution is recommended in patients with histories of significant allergies and/or asthma.

Periodic monitoring of renal, hepatic, and hematologic function is recommended during high-dose or prolonged therapy because the risk of neutropenia and serum sickness-like reactions may be increased.

Use of antibiotics may result in overgrowth of nonsusceptible organisms, including fungi. Appropriate measures should be taken if superinfection occurs.

In patients with streptococcal infections, clinicians should take measure to ascertain that therapy is sufficient to eradicate the organism and to prevent streptococcal sequelae.

To reduce the risk of development of drug-resistant organisms, antibiotics should only be used to treat or prevent proven or suspected infections caused by bacteria. Culture and susceptibility information should be considered when selecting treatment or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy. Ambulatory patients should be advised to avoid missing doses and to complete the entire course of therapy.

Dialysis

Data not available

Other Comments

Oral penicillin should be taken on an empty stomach 1 hour before or 2 hours after meals.

Oral penicillin should not be used for the treatment of patients with severe infections, or with nausea, vomiting, gastric dilatation, cardiospasm, or intestinal hypermotility.

Penicillin V potassium: 250 mg = 400,000 units; 500 mg = 800,000 units

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