Drugs: Mecillinam, Pivmecillinam.
Therapeutic Uses includes
| - Bacteria | - Disease |
|---|---|
| - Streptococcus spp | - Wound sepsis, puerperal fever acute throat infections, subacute bacterial endocarditis,.. etc. |
| - Staphylococcus spp | - Infections of skin, mucous membrane and bone. |
| - Pneumococcus spp | - Pneumonia and empyema. |
| - Spirochetes | - Syphilis and gonorrhoea. |
| - Gram –ve | - Meningococcal infections (Meningitis) |
| - Pseudomonas | - Pneumonia, Exterenal otitis, endopthalmitis.. etc |
| - Actinomyces and others | - Actinomycosis, Anthrax and H. influenza infections. - Diphtheria, tetanus and gas gangrene - Penicillin may be used together with the specific antitoxins. - Peptic ulcer |
Side Effects
1) Hypersensitivity (10% of the patients)
Common with long courses. Due to metabolites not penicillin itself
| - Early / Anaphylactic (Type I) | - Delayed / Serum sickness (Type III) |
|---|---|
| - Severe fall in BP - Bronchoconstriction - Angioedema (Larynx) - Can cause death - Minutes (IV) to Less than an hour (Oral) | - Fever, Malasie, Arthalgia, Skin rash, Angioedema - 2-12 Days |
- Prevention: History and Hypersensitivity test
- Treatment: ECAA: #Epinephrine / #Corticosteroids / Anti-Histamine (Chlorpheniramine)/ and #Aminophylline
2) Neurotoxicity
Intrathecal injections: Seizures, Coma and Death.
3) Glossitis, Stomatitis, and Superinfection
By Candida Albicanis more with Ampicillin
4) Cation Toxicity (Renal Insufficiency patients)
Procaine Penicillens
5) Accidental IV administration
causes mental changes, convulsions, and Pulmomary infarcts
Interactions
-
Penicillin shouldn’t be with bacteristatic drugs (eg. Tetracycline,
-
Chloramphenicol, Erythromycin). Inhibiting protein synthesis interferes with penicillin
-
Gentamicin and Anti-psuedomonals have SYNERGITIC effect. Penicillin makes the penetration easier for Aminoglycosides
But they cancel each other’s work when prepared in the same needle, even preferably not in the same site