What is the recommended dose of Penicillin V (Penicillin) for a 60.6kg male with streptococcal pharyngitis?

From the Guidelines

For a 60.6kg male with strep pharyngitis, the recommended dose of Penicillin VK is 250 mg four times daily or 500 mg twice daily for 10 days, as indicated by the most recent and highest quality study 1. This standard adult dosing is appropriate for this patient's weight. The full 10-day course should be completed even if symptoms improve before then to ensure complete eradication of Group A Streptococcus bacteria and prevent complications like rheumatic fever. Some key points to consider when treating strep pharyngitis include:

• Penicillin VK should be taken on an empty stomach, 1 hour before or 2 hours after meals for optimal absorption.
• Common side effects may include gastrointestinal disturbances such as nausea or diarrhea.
• Penicillin remains the first-line treatment for strep pharyngitis due to its narrow spectrum of activity, which helps prevent antimicrobial resistance, and because Group A Streptococcus has remained universally susceptible to penicillin over decades of use, as supported by studies such as 1 and 1.
• If the patient has a penicillin allergy, alternatives like azithromycin or clindamycin would be considered instead, with dosing recommendations as outlined in 1.

From the FDA Drug Label

The usual dosage recommendations for adults and children 12 years and over are as follows: Streptococcal Infections Mild to moderately severe – of the upper respiratory tract and including scarlet fever and erysipelas: 125 to 250 mg (200,000 to 400,000 units) every 6 to 8 hours for 10 days The recommended dose of Penicillin VK for a 60.6kg male with strep pharyngitis is 125 to 250 mg every 6 to 8 hours for 10 days 2.

• The dosage is based on the severity of the infection and the clinical response of the patient.
• The patient's weight is not a direct factor in determining the dose, as the recommended dosage is the same for adults and children 12 years and over.

From the Research

Penicillin VK Dosing for Strep Pharyngitis

• The dosing of Penicillin VK for strep pharyngitis is typically 250 mg, three times daily 3.
• In children, the dose is 13.3 mg/kg, three times daily for 10 days 4.
• For a 60.6kg male, the dose would be approximately 250 mg, three times daily, as the studies do not provide a specific dose for adults based on weight.
• The treatment duration is usually 10 days 5.

Efficacy and Safety

• Penicillin VK has been shown to be effective in treating strep pharyngitis, with clinical cure rates ranging from 86% to 98% 3, 6.
• The bacteriological cure rate for Penicillin VK has been reported to be around 87% to 97% 3, 6.
• Penicillin VK is generally well-tolerated, with few adverse events reported 3, 6, 7.

Comparison to Other Antibiotics

• Clarithromycin has been compared to Penicillin VK in several studies, with similar clinical and bacteriological efficacy 3, 4, 6, 7.
• However, the choice of antibiotic may depend on factors such as patient allergy history and local resistance patterns 5.