RT Book, Section
A1 Lowry, Adam W.
A1 Bhakta, Kushal Y.
A1 Nag, Pratip K.
SR Print(0)
ID 7441352
T1 Chapter 20. Infectious Disease
T2 Texas Children's Hospital Handbook of Pediatrics and Neonatology
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-163924-8
LK accesspediatrics.mhmedical.com/content.aspx?aid=7441352
RD 2024/04/23
AB Table  Graphic  Jump  Location|Download  (.pdf)|PrintPenicillinsBactericidal:  Inhibit  bacterial  cell  wall  synthesis  via  competitive  inhibition  of  transpeptidaseClassExamplesAntimicrobial  SpectrumAdverse  EffectsMiscellaneousNarrow  spectrum  (β-lactamase  susceptible)Penicillin  G  (IV)Benzathine  penicillin  G  (IM)Procaine  penicillin  G  (IM)Penicillin  V  (PO)Streptococcus  Group  A,  B,  viridansMost  Streptococcus  pneumoniaeTreponema  pallidumNeisseria  meningitidisActinomyces  spp.Pasteurella  multocidaSome  anaerobesAnaphylaxisRashDrug  feverBone  marrow  suppressionHemolytic  anemiaInterstitial  nephritisRenal  impairmentPenicillin  V  is  acid  stable  in  the  stomachResistance  caused  by  degradation  of  antibiotic  by  bacterial  penicillinasesAminopenicillinsAmpicillin  (IV,  IM,  PO)Amoxicillin  (PO)Streptococcus  Group  A,  B,  viridansS.  pneumoniaeEnterococcus  spp.Listeria  monocytogenesHaemophilus  influenzae  if  β-lactamase  negativeKingella  kingaeSome  gram-  negative  organisms:  Escherichia  coli,  Salmonella  spp.,  Shigella  spp.,  Proteus  spp.GI  disturbanceElevated  LFTsBone  marrow  suppressionHemolytic  anemiaAllergic  reactionRenal  impairmentBetter  PO  with  amoxicillin  than  ampicillinβ-Lactamase  resistant  (antistaphylococcal  penicillins)Nafcillin  (IV)Oxacillin  (IV)Dicloxacillin  (PO)S.  aureus  (MSSA)Streptococcus  Group  A,  B,  viridansS.  pneumoniaeInterstitial  nephritisRenal  impairmentHepatic  toxicityBone  marrow  suppressionAllergic  reactionNo  activity  against  gram-negative  organismsNafcillin  causes  more  phlebitis  than  oxacillin  (decreased  with  slow  infusion,  large-gauge  IV)Antipseudomonal  penicillinsPiperacillin  (IV)Ticarcillin  (IV)Carbenicillin  (PO)Pseudomonas  aeruginosaStreptococcus  Group  A,  B,  viridansS.  pneumoniaeEnterococcus  spp.Some  gram-negative  →  Escherichia  coli,  Enterobacter  spp.,  Salmonella  spp.,  Shigella  spp.,  Proteus  spp.,  Citrobacter  spp.,  Haemophilus  spp.Neisseria  spp.Platelet  dysfunctionHigh  Na  loadHypokalemiaSerum  sicknessBone  marrow  suppressionRenal  impairmentS.  viridans  and  Enterococci  are  only  30%-60%  susceptiblePenicillin  +  β-lactamase  inhibitorAmoxicillin  +  clavulanate  (PO)Ticarcillin  +  clavulanate  (IV)Ampicillin  +  sulbactam  (IV)Piperacillin  +  tazobactam  (IV)Streptococcus  Group  A,  B,  viridansS.  pneumoniaeEnterococcus  spp.S.  aureus  (MSSA)Gram-negative  organisms:  E.  coli,  Klebsiella  spp.,  Salmonella  spp.,  Shigella  spp.,  Proteus  spp.,  Aeromonas  spp.,  Pasteurella  multocidaP.  aeruginosa  (piperacillin/tazobactam  and  ticarcillin/  clavulanate)AnaerobesGI  disturbanceDiarrhea  (especially  amoxicillin/clavulanate)RashRenal  impairmentS.  viridans  and  Enterococci  are  only  30%–60%  susceptible  to  ticarcillin/clavulanate  and  piperacillin/tazobactam