Penicillin V Treatment of Beta-Hemolytic Streptococcal Infections in Children

Early origins of oral penicillin dosing for children

“…These rules may have underpinned the dosing guidance used when formulating the BNF doses in 1963, yet there is little evidence to support this. It is important to note that the reported doses of oral penicillin V in paediatrics did vary internationally through the 1950s with Breese and Disney reporting using doses of 250 mg three times daily for children of all sizes and ages in 1956 8. Lamb and Maclean published a study in 1957 using penicillin V doses of 120 mg six hourly for adults and only 60 mg six hourly for children, keeping the principle of a child being half an adult, but doubling the values of those suggested in the BMJ in 1955 5 9.…”

The Importance of Bacteriologic Eradication in the Treatment of Group A Streptococcal Tonsillopharyngitis

“…Group A β-hemolytic streptococci tonsillopharyngitis penicillin treatment failure over time 7,[18][19][20][21][22][23][24][25][26][27][28][29]. …”

“…11-14 Injectable benzathine penicillin solves adherence problems, but there is a reluctance to use it because of concern about allergic (anaphylactic) reactions, [15][16][17] pain on administration, and a trend for falling efficacy ( Figure 2). 7,[18][19][20][21][22][23][24][25][26][27][28][29] Although antibiotics produce alleviation of symptoms of GABHS tonsillopharyngitis, it is extremely important to know that all patients will spontaneously improve even without treatment. The natural course of GABHS tonsillopharyngitis is a rapid onset of symptoms and signs of infection, with spontaneous resolution of signs and symptoms within 2 to 5 days.…”