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Prescribing for minor illness
Published in Gina Johnson, Ian Hill-Smith, Chirag Bakhai, The Minor Illness Manual, 2018
Gina Johnson, Ian Hill-Smith, Chirag Bakhai
If the patient has a true allergy to one type of penicillin, all drugs of this class should be avoided. This does not apply if the patient experiences non-allergic side effects, such as diarrhoea with co-amoxiclav; phenoxymethylpenicillin may not produce this side effect. If penicillin is the first-line treatment but cannot be used because of a known penicillin sensitivity, the usual alternative is clarithromycin because it is a macrolide of very different structure to penicillin, and the spectrum of activity is similar. However, this too may be undesirable in view of its drug interactions. Azithromycin helps to overcome this problem, but both drugs are not recommended in pregnancy or for patients with a long QT interval. For further information, see the sections on Prescribing in Pregnancy and QT Interval. Cefalexin is the final alternative and can be used for patients sensitive to penicillin unless they have had an anaphylactic reaction to penicillin previously.
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Published in Caroline Ashley, Aileen Dunleavy, John Cunningham, The Renal Drug Handbook, 2018
Caroline Ashley, Aileen Dunleavy, John Cunningham
Antibacterials: absorption of phenoxymethylpenicillin reduced; increased risk of nephrotoxicity with colistimethate or polymyxins and possibly cephalosporins; increased risk of ototoxicity and nephrotoxicity with capreomycin or vancomycin.
Information on level of drugs into breastmilk
Published in Wendy Jones, Breastfeeding and Medication, 2013
Penicillins This group of drugs is bactericidal and interferes with cell wall synthesis. Allergic reactions are reported to occur in up to 10% of the population, normally evident as rashes. However, an anaphylactic reaction is possible in 0.05% of patients. Those with a previous reaction are more at risk. A child exposed to penicillin for the first time through its mother's milk is highly unlikely to react but may do so subsequently having been sensitised. It is also possible that a reaction will occur the first time the child receives its own dose of medication. Phenoxymethylpenicillin
Dental implant procedures contribution to the total antibiotic use in Swedish dentistry. A register-based study
Published in Acta Odontologica Scandinavica, 2023
Margareta Hultin, Bodil Lund, Frida Lundgren, Andreas Cederlund
Although the prescriptions of phenoxymethylpenicillin have declined considerably during the study period this finding shows that prolonged prophylaxis or longer antibiotic treatment during initial healing still is very common. Recent reviews have also questioned the benefit of antibiotic prophylaxis and/or extended treatment in uncomplicated implant surgery in otherwise healthy patients [7,32] which also have been confirmed in placebo-controlled studies [33]. This finding shows that there is still room for improvement in reducing the rate of prescriptions of antibiotics in connection with implant surgery especially since a majority of treatments performed were placement of a single implant which in most cases are uncomplicated procedures compared to insertion of multiple implants. In order for recommendations to have viable legitimacy, regular audits and up-dates are needed based on latest scientific evidence and a multidisciplinary approach.
Throat infections and use of streptococcal antigen test and antibiotic treatment in general practice; a web-based survey
Published in Scandinavian Journal of Primary Health Care, 2022
Hanne Puntervoll, Pål Jenum, Sigurd Høye, Mette Tollånes
In our survey, most of the GPs (95%) would prescribe beta-lactamase-sensitive penicillin. This is in accordance with guidelines, which recommend phenoxymethylpenicillin as first-line treatment for most respiratory tract infections when antibiotic therapy is indicated. Approximately 4–5% of the GPs indicated that they would offer broad-spectrum antibiotics. Macrolides were also suggested by a few GPs. Treatment of upper respiratory tract infections with second-choice antibiotics is almost always unnecessary. Hence, treatment with broad-spectrum antibiotics in cases 1 and 2 would not be in accordance with guidelines. These findings are consistent with previous reports showing that macrolides and penicillin with extended-spectrum are used more often than recommended [18,19]. The use of macrolide antibiotics is particularly problematic as they may trigger microbial resistance [20].
Outcome in children with newly diagnosed rheumatic heart disease in Indonesia
Published in Paediatrics and International Child Health, 2021
Indah K. Murni, Nadya Arafuri, Andrew C. Steer, M. Taufik Wirawan, Fransisca G. W. Remi, Noormanto Noormanto, Sasmito Nugroho
CRP is an independent predictor of progression of calcific aortic valve disease, coronary artery disease and atheroma formation [14]. A previous study also found that patients with RHD and a high plasma CRP level were more likely to develop atrial fibrillation and to progress to mitral stenosis [15]. This study raises the possibility that, after untreated rheumatic fever, chronic inflammation of the cardiac valves may continuously occur and lead to more rapid progression of valvular damage [16]. In this study, recurrence of acute rheumatic fever was not associated with valve progression. It is well known that recurrence of acute rheumatic fever is an important factor in valvular progression in RHD [7] and is the reason why secondary antibiotic prophylaxis is recommended for patients with RHD [7,17]. A meta-analysis found that intramuscular benzathine penicillin G was the antibiotic of choice for preventing recurrence of acute rheumatic fever [18,19]. At this hospital, however, benzathine penicillin G is unavailable and so daily oral phenoxymethylpenicillin is used for secondary prophylaxis. Adherence to daily oral penicillin is known to be poor [18]. It was not possible to measure adherence properly in this study because children are managed by their district hospital after discharge which makes data collection challenging [9].