ISLAMIC UNIVERSITY IN UGANDA-MBALE

SCHOOL OF NURSING AND MIDWIFERY

CERTIFICATE IN NURSING 2/2
PENICILLINS
Penicillins are among the most widely used antibiotic agents. Penicillins are also called
beta-lactams, which is a term relating to their chemical structure. They are all virtually
bactericidal agents with a similar chemical structure and, therefore, a similar
mechanism of action.
Classification of Penicillins
A. Natural Penicillins
These are highly effective against gram-positive Cocci but ineffective against most
strains of staphylococcus aureus. They are readily destroyed by enzyme penicillinase
(beta lactamase enzyme). Examples include;
 Benzyl penicillin (Penicillin G)/ X-Pen
 Phenoxymethyl penicillin (Penicillin V)/ Pen V
B. Penicillinase resistant penicillins
These have a narrow spectrum of activity and are resistant to degradation by
penicillinase enzyme. These drugs are useful in treating S. Aureus infections. Examples
are;
 Cloxacillin
 Flucloxacillin etc.
C. Broad-spectrum penicillins (Aminopenicillins)
They have a wide spectrum of activity against both the Gram-negative and Gram-
positive bacteria. Examples are;
 Ampicillin
 Amoxicillin
 Amoxicillin + Clavulanic acid
Note that penicillins differ in the following:
1. Chemical stability in stomach acid
2. Susceptibility to penicillinase (beta lactamase) destruction
3. Spectrum of action, i.e., narrow or extended
4. Route of administration
5. Duration of action
6. Site of action

BY BWAMBALE ASINAN
©2020
 ISLAMIC UNIVERSITY IN UGANDA-MBALE
SCHOOL OF NURSING AND MIDWIFERY
CERTIFICATE IN NURSING 2/2
TABLE OF PENICILLINS
Penicillin Spectrum Indication Contra- Usual Side effects Nursing
indication Dose implication
Amoxicillin Extended -Pneumonia -Known Adults & -Nausea 3g of amoxicillin
-UTI hypersensiti children -Diarrhea may be
-Otitis media vity to over 20 kg: -Skin rash administered
-Dental abscess penicillins 250–500 -Hepatitis orally with 1 g of
-Sinusitis -infectious mg every 8 -Urticaria probenecid in
-H. Pylori mononucleos hours -Hemolytic the treatment of
eradication is Children anemia uncomplicated
-Acute -Penicillin under 20 gonorrheal
cholecystitis associated kg: 20–40 infections in
-Biliary tract jaundice mg/kg/day adults. Also used
infections, etc. in divided for otitis media
doses
every 8
hour
Amoxicillin Extended -Pneumonia -Known Adults: -Nausea As both the 250
and -UTI hypersensiti One 250 -Diarrhea and the 500
Potassium -Otitis media vity to mg or one -Vomiting tablets contain
Clavulanat -Sinusitis penicillins 500 mg -Urticaria the same amount
e -Wound -History of tablet -Gastritis of potassium
infections penicillin or every 8–12 -Vaginitis clavulanate, two
-Cellulitis amoxicillin hours -Anorexia 250 tablets are
-Tonsillitis with Children: -Indigestion not equivalent to
-Urethritis clavulanic 20–40 -Antibiotic one 500mg
-Boils acid- mg/kg/day associated tablet. The
-Intra- associated in 3 colitis suspension
abdominal jaundice or divided -Abdominal should be
sepsis hepatic doses discomfort refrigerated
-Septic dysfunction -Chronic upon
abortion bronchitis reconstitution.
-Etc. Unused portions
should be
discarded after
10 days
Cloxacillin Narrow -Septicemia -Known Adults & -Antibiotic Administer 1
-Staph hypersensiti children associated hour before or 2
endocarditis vity to over 20 kg: colitis hours after
-Septic penicillins 250 mg– -Joint pains meals. Peak
arthritis 1.0 g every -Hemolytic plasma levels 7–
-Prophylaxis in 6 hours anemia 15 mcg/ml after
bone and joint Children -Candidiasis 30–60 min.
surgery less than -Pain and
-Impetigo 20 kg: 50– inflammatio

BY BWAMBALE ASINAN
©2020
 ISLAMIC UNIVERSITY IN UGANDA-MBALE
SCHOOL OF NURSING AND MIDWIFERY
CERTIFICATE IN NURSING 2/2
-Cellulitis 100 n at injection
-Pneumonia mg/kg/day site
-Osteomyelitis in equally -Diarrhea
-Etc. divided -Nausea
doses -Vomiting
every 6 -Skin rash
hours -Urticaria
-Hepatitis

Other examples of penicillins include:

 Penicillin V/ Pen V
 Ampicillin
 Flucloxacillin
 Benzyl Penicillin/ X-pen
 Procaine Penicillin/ ppf
 Benzathine penicillin
 Ampicillin + Cloxacillin/ ampiclox
 Flucloxacillin + Amoxicillin/ Flucamox
 Etc.

BY BWAMBALE ASINAN
©2020