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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › BETA-LACTAM ANTIBACTERIALS, PENICILLINS › Penicillins with extended spectrum
epicillin
J01CA07
Forms & Strengths
- Oral capsules: 250 mg, 500 mg
- Oral suspension: 125 mg/5 mL, 250 mg/5 mL
- Powder for injection: 250 mg, 500 mg, 1 g, 2 g
Adult Dosing
- Mild to moderate infections (respiratory, urinary tract, skin): 250 mg to 500 mg orally every 6 hours
- Severe infections: 1 g to 2 g intravenously or intramuscularly every 4 to 6 hours
- Maximum daily dose: 12 g intravenously
Pediatric Dosing
- Children over 1 month, mild to moderate infections: 50 to 100 mg/kg/day orally divided in equally spaced doses every 6 hours
- Severe infections: 100 to 200 mg/kg/day intravenously or intramuscularly divided in equally spaced doses every 4 to 6 hours
- Neonates: Safety and efficacy not fully established
Indications
- Treatment of upper and lower respiratory tract infections caused by susceptible organisms
- Urinary tract infections caused by susceptible strains of E. coli, P. mirabilis, and enterococci
- Skin and soft tissue infections caused by susceptible staphylococci and streptococci
Mechanism of Action
- Semisynthetic broad-spectrum aminopenicillin
- Inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins (PBPs)
- Leads to inhibition of peptidoglycan synthesis and subsequent lysis of the bacterial cell
Contraindications
- Hypersensitivity to epicillin or other penicillins
- History of penicillin-associated cholestatic jaundice or hepatic dysfunction
Adverse Reactions
- Diarrhea, nausea, vomiting, glossitis, stomatitis
- Hypersensitivity reactions including urticaria, rash, pruritus, anaphylaxis
- Transient elevation of serum transaminases
- Superinfection with resistant organisms or yeast overgrowth during prolonged use
Drug Interactions
- Probenecid decreases renal tubular secretion of epicillin, resulting in higher and more prolonged serum concentrations
- May reduce the efficacy of oral contraceptives containing estrogen
- Concomitant use with bacteriostatic antibiotics (e.g., chloramphenicol, erythromycin, tetracyclines) may antagonize the bactericidal effect of penicillins
Curated Content: Needs Vetting Before Put to Clinical Use