Abstract
Severe streptococcal infections are commonly treated with intravenous followed by oral penicillin (pheneticillin) therapy. However, switching from iv to oral therapy is complicated by the variability in oral pheneticillin absorption. We employed an Oral Absorption Test (OAT) for pheneticillin to identify patients in whom oral pheneticillin absorption is poor. Out of 84 patients 30 patients (36%) were identified as insufficient absorbers. Treatment failure due to pheneticillin malabsorption can be avoided by performing an OAT, and these patients should be treated by another antibiotic, which is known to be absorbed well.
Highlights
In the Netherlands, patients with severe streptococcal infections are effectively treated with narrow-spectrum antibiotics, most frequently with initial intravenous (iv) penicillin G followed by oral maintenance therapy, usually with pheneticillin
The advantages of this treatment approach are the bactericidal activity of penicillin, the low costs, the possibility to switch to an oral antibiotic as soon as possible, and the lower risk of introducing resistance associated with narrow-spectrum antibiotics
The purpose of this report is to describe our findings with the oral absorption test (OAT) implemented in our medical center
Summary
In the Netherlands, patients with severe streptococcal infections are effectively treated with narrow-spectrum antibiotics, most frequently with initial intravenous (iv) penicillin G followed by oral maintenance therapy, usually with pheneticillin. The advantages of this treatment approach are the bactericidal activity of penicillin, the low costs, the possibility to switch to an oral antibiotic as soon as possible, and the lower risk of introducing resistance associated with narrow-spectrum antibiotics. The disadvantage is the highly variable absorption of pheneticillin [1], and patients in whom adequate dosing is critical should undergo an oral pheneticillin absorption test before switching to oral pheneticillin maintenance therapy. The purpose of this report is to describe our findings with the oral absorption test (OAT) implemented in our medical center
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