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Phenoxymethylpenicillin, commonly known as penicillin V, is a penicillin antibiotic that is orally active. It is less active than benzylpenicillin (penicillin G) against Gram-negative bacteria.^[1]^[2] Phenoxymethylpenicillin is more acid-stable than benzylpenicillin, which allows it to be given orally. It exerts a bactericidal action against penicillin-sensitive microorganisms during the stage of active multiplication. It acts by inhibiting the biosynthesis of cell-wall peptidoglycan. It is not active against beta-lactamase-producing bacteria, which include many strains of staphylococci.^[3]

Phenoxymethylpenicillin has a range of antimicrobial activity against Gram-positive bacteria that is similar to that of benzylpenicillin and a similar mode of action, but it is substantially less active than benzylpenicillin against Gram-negative bacteria.^[1]^[2]

Phenoxymethylpenicillin is usually used only for the treatment of mild to moderate infections, and not for severe or deep-seated infections since absorption can be unpredictable. Except for the treatment or prevention of infection with Streptococcus pyogenes (which is uniformly sensitive to penicillin), therapy should be guided by bacteriological studies (including sensitivity tests) and by clinical response.^[3] Patients treated initially with parenteral benzylpenicillin may continue oral treatment with phenoxymethylpenicillin once a satisfactory clinical response has been obtained.^[4]

For prophylaxis against rheumatic fever, phenoxymethylpenicillin given orally twice a day is used as an alternative to injections of benzathine penicillin given every two weeks.

Medical uses[edit]

Specific indications for phenoxymethylpenicillin include:^[4]^[5]

Infections caused by Streptococcus pyogenes
- Tonsillitis
- Pharyngitis
- Skin infections
Anthrax (mild uncomplicated infections)
Lyme disease (early stage in pregnant women or young children)
Rheumatic fever (primary and secondary prophylaxis)
Streptococcal skin infections
Spleen disorders (pneumococcal infection prophylaxis)
Initial treatment for Dental Abscesses
Moderate-to-severe gingivitis (with metronidazole)
Avulsion injuries of teeth (as an alternative to tetracycline)

Penicillin V is sometimes used in the treatment of odontogenic infections.

Adverse effects[edit]

Further information: Penicillin drug reaction

Phenoxymethylpenicillin is usually well tolerated but may occasionally cause transient nausea, vomiting, epigastric distress, diarrhea, and black hairy tongue. A previous hypersensitivity reaction to any penicillin is a contraindication.^[3]^[4]

Compendial status[edit]

British Pharmacopoeia ^[6]

References[edit]

^ ^a ^b Garrod, L. P. (1960). "Relative Antibacterial Activity of Three Penicillins". British Medical Journal (5172): 527–29.
^ ^a ^b Garrod, L. P. (1960). "The Relative Antibacterial Activity of Four Penicillins". British Medical Journal (5214): 1695–6.
^ ^a ^b ^c "Penicillin V Potassium tablet: Drug Label Sections". U.S. National Library of Medicine, Daily Med: Current Medication Information. 12/2006. Retrieved 2009-08-02.
^ ^a ^b ^c Sweetman S., ed. (2002). Martindale: The complete drug reference (Electronic version ed.). London: Royal Pharmaceutical Society of Great Britain and the Pharmaceutical Press.
^ Rossi S., ed. (2006). Australian Medicines Handbook. Adelaide: Australian Medicines Handbook Pty Ltd. ISBN 0-9757919-2-3.
^ British Pharmacopoeia Commission Secretariat. "Index (BP 2009)". Retrieved 26 March 2010.

UpToDate Contents

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1. 連鎖球菌扁桃咽頭炎の治療および予防 treatment and prevention of streptococcal tonsillopharyngitis
2. 急性リウマチ熱の治療および予防 treatment and prevention of acute rheumatic fever
3. 蜂窩識炎および丹毒 cellulitis and erysipelas
4. エリジペロスリックス感染 erysipelothrix infection
5. 炭疽の治療 treatment of anthrax

English Journal

The management of cellulitis in emergency departments: antibiotic-prescribing practices and adherence to practice guidelines in Ireland.

Quirke M1, Saunders J, O'Sullivan R, Wakai A.
European journal of emergency medicine : official journal of the European Society for Emergency Medicine.Eur J Emerg Med.2015 Feb 23. [Epub ahead of print]
OBJECTIVES: There is a lack of evidence to guide the management of cellulitis in the emergency department (ED). The primary aim of this study was to characterize antibiotic-prescribing practices for the treatment of cellulitis in Irish EDs. Secondary aims were to identify patient variables associate
PMID 25647040

Intact cell mass spectrometry as a progress tracking tool for batch and fed-batch fermentation processes.

Helmel M1, Marchetti-Deschmann M1, Raus M2, Posch AE3, Herwig C3, Šebela M2, Allmaier G4.
Analytical biochemistry.Anal Biochem.2015 Feb 1;470:25-33. doi: 10.1016/j.ab.2014.10.008. Epub 2014 Oct 22.
Penicillin production during a fermentation process using industrial strains of Penicillium chrysogenum is a research topic permanently discussed since the accidental discovery of the antibiotic. Intact cell mass spectrometry (ICMS) can be a fast and novel monitoring tool for the fermentation progre
PMID 25447465

Use of antibiotics in children: a danish nationwide drug utilization study.

Pottegård A1, Broe A, Aabenhus R, Bjerrum L, Hallas J, Damkier P.
The Pediatric infectious disease journal.Pediatr Infect Dis J.2015 Feb;34(2):e16-22. doi: 10.1097/INF.0000000000000519.
BACKGROUND: We aimed to describe the use of systemic antibiotics among children in Denmark.METHODS: National data on drug use in Denmark were extracted from the Danish National Prescription Database. We used prescription data for all children in Denmark aged 0 to 11 years from January 1, 2000 to Dec
PMID 25144795

Japanese Journal

<Abstract of Published Report>Application of Ion-exchange Cartridge Clean-up in Food Analysis IV. : Confirmatory Asay of Benzylpenicillin, Phenoxymethylpenicillin, Oxacillin, Cloxacillin, Nafcillin and Dicloxacillin in Bovine Tissues by Liquid Chromatography-Electrospray Ionization Tandem Mass Spectmetry.

ITO Yuko,IKAI Yoshitomo,OKA Hisao,MATSUMOTO Hiroshi,MIYAZAKI Yutaka,TAKEBA Kazue,NAGASE Hisamitsu
岐阜藥科大學紀要 51, 67, 2002-06-30
NAID 110000054632

In vitro lymphocyte proliferation in the diagnosis of allergy to phenoxymethylpenicillin

CEDERBRANT K
Allergy 53, 1155-1161, 1998
NAID 30027679325

Related Pictures

★リンクテーブル★

リンク元	「ペニシリンV」「PCV」
拡張検索	「phenoxymethylpenicillin benzathine」「phenoxymethylpenicillin potassium」「benzathine phenoxymethylpenicillin」

「ペニシリンV」

Penicillin V
Systematic (IUPAC) name
	3,3-dimethyl-7-oxo-6-(2-phenoxyacetamido)-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid
Clinical data
Trade names	Veetids
AHFS/Drugs.com	monograph
MedlinePlus	a685015
Licence data	US Daily Med:link
Pregnancy cat.	B (US)
Legal status	℞ Prescription only
Routes	enteral
Pharmacokinetic data
Bioavailability	60%
Protein binding	80%
Metabolism	hepatic
Half-life	30–60 min
Excretion	renal
Identifiers
CAS number	87-08-1 , 132-98-9 (potassium), 147-48-8 (anhydrous calcium), 73368-74-8 (calcium dihydrate)
ATC code	J01CE02
PubChem	CID 6869
DrugBank	DB00417
ChemSpider	6607
UNII	Z61I075U2W
KEGG	D05411
ChEBI	CHEBI:27446
ChEMBL	CHEMBL615
Chemical data
Formula	C16H18N2O5S
Mol. mass	350.39 g/mol
	SMILES OC(=O)[C@@H]2N3C(=O)[C@@H](NC(=O)Cc1ccccc1)[C@H]3SC2(C)C;
	InChI InChI=1S/C16H18N2O5S/c1-16(2)12(15(21)22)18-13(20)11(14(18)24-16)17-10(19)8-23-9-6-4-3-5-7-9/h3-7,11-12,14H,8H2,1-2H3,(H,17,19)(H,21,22)/t11-,12+,14-/m1/s1 ; Key:BPLBGHOLXOTWMN-MBNYWOFBSA-N ;
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