|Trade names||Veetids, Apocillin, others|
|Other names||penicillin phenoxymethyl, penicillin V, penicillin VK|
|Defined daily dose||2 grams|
|Elimination half-life||30–60 min|
|Chemical and physical data|
|Molar mass||350.39 g·mol−1|
|3D model (JSmol)|
Phenoxymethylpenicillin, also known as penicillin V (PcV) and penicillin VK, is an antibiotic useful for the treatment of a number of bacterial infections. Specifically it is used for the treatment of strep throat, otitis media, and cellulitis. It is also used to prevent rheumatic fever and to prevent infections following removal of the spleen. It is given by mouth.
Side effects include diarrhea, nausea, and allergic reactions including anaphylaxis. It is not recommended in those with a history of penicillin allergy. It is relatively safe for use during pregnancy. It is in the penicillin and beta lactam family of medications. It usually results in bacterial death.
Phenoxymethylpenicillin was first made in 1948. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. The wholesale cost in the developing world is about US$0.05–0.96 per day. In the United States a course of treatment costs less than $25. In 2017, it was the 242nd most commonly prescribed medication in the United States, with more than two million prescriptions.
- Infections caused by Streptococcus pyogenes
- 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)
- Blood infection prophylaxis in children with sickle cell disease.
Penicillin V is sometimes used in the treatment of odontogenic infections.
It is less active than benzylpenicillin (penicillin G) against Gram-negative bacteria. 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.
Phenoxymethylpenicillin is more acid-stable than benzylpenicillin, which allows it to be given orally.
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. People treated initially with parenteral benzylpenicillin may continue treatment with phenoxymethylpenicillin by mouth once a satisfactory response has been obtained.
The defined daily dose is 2 grams (by mouth). In those who are 40 kg or more this is generally given as 1 gm twice per day while those who weight 20 to 40 kg are treated with 500 mg twice per day. Children under 6 years old may be treated with 250 mg twice per day while those under 1 year old may be treated with 125 mg twice per day.
Phenoxymethylpenicillin is usually well tolerated but may occasionally cause transient nausea, vomiting, epigastric distress, diarrhea, constipation, acidic smell to urine and black hairy tongue. A previous hypersensitivity reaction to any penicillin is a contraindication.
Mechanism of action
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.
Society and culture
The wholesale cost in the developing world is about US$0.05–0.96 per day. In the United States a course of treatment costs less than $25. In 2017, it was the 242nd most commonly prescribed medication in the United States, with more than two million prescriptions.
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