Penicillin V for prevention of pneumococcal infection

This leaflet is about the use of penicillin V for preventing infections caused by pneumococcal bacteria in children with sickle cell disease and those whose spleen is not working or has been removed (called asplenia). Use of antibiotics in this way is sometimes called antibiotic prophylaxis.

Information Standard quality markThis leaflet has been written specifically about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Penicillin V helps prevent life-threatening infections

Children with sickle cell disease and those without a spleen have difficulty fighting infections, particularly pneumococcal infection, and they risk becoming seriously ill. By giving penicillin V regularly, you can protect your child from these infections.

The penicillin helps your child to fight infection. It does not weaken their immune system. 

You must give the penicillin every day to protect your child, even if they seem well.

If your child is allergic to any antibiotics, check with your doctor that your child can have penicillin V before starting it.

Name of drug

Penicillin V (also known as phenoxymethylpenicillin)

Why is it important for my child to take this medicine?

The spleen is an important organ that helps the body to fight infections caused by bacteria and other germs. Sometimes a child’s spleen has to be removed. In others, including those with sickle-cell anaemia, the spleen doesn’t work properly. This makes it harder for the body to fight bacteria, and children risk getting serious infections, becoming very ill and occasionally dying. 

Giving penicillin V regularly will help to kill pneumococcal bacteria (which cause serious infections such as pneumonia, septicaemia and meningitis). You must continue to give it every day, even if your child seems well, as infections can develop slowly and without many symptoms.

What is penicillin V available as?

  • Tablets: 250 mg
  • Liquid medicine: 125 or 250 mg in 5 mL

When should I give penicillin V?

Penicillin V for protection against infections is given once or twice each day. 

  • Once a day: this can be in the morning or the evening. 
  • Twice a day: this should be in the morning and the evening.

Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount (the dose) that is right for your child. The dose will be shown on the medicine label. 

It is important that you follow your doctor’s instructions about how much to give.

Note that when penicillin V is given to prevent infection, a lower dose is used than when treating an infection and it is given only once or twice each day.

How should I give it?

This medicine works best when the stomach is empty, so try to give it to your child ½–1 hour before they eat. However, if your child has an upset stomach, you can give it with a small amount of food.

Tablets
Tablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet.


Liquid medicince
Liquid medicine: Measure out the right amount using an oral syringe or medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

When should the medicine start working?

The medicine will start to protect your child from infection when they have been taking it for a few days. However, you won’t see any difference in your child. 

You must continue to give penicillin to your child every day, even if they seem well, so that they are protected from infection.

What if my child is sick (vomits)?

  • If your child is sick less than 30 minutes after having a dose of penicillin, give them the same dose again.
  • If your child is sick more than 30 minutes after having a dose of penicillin, you do not need to give them another dose. Wait until the next normal dose.

If your child is sick and has a fever (temperature higher than 38°C) or seems unwell, take them to a doctor, in case they are developing an infection.

What if I forget to give it?

If you normally give in once each day in the morning: Give the missed dose when you remember during the day.

If you normally give in once each day in the evening: If you remember before bedtime, give the missed dose. If you remember after this, you do not need to wake your child up to give them the missed dose. You can give the missed dose in the morning, as long as this is at least 4 hours before the evening dose is due.

If you normally give it twice each day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7 am, you can give the missed dose at any time up to 11 am. If you remember after that time, do not give the missed dose. Wait until the next normal dose.

What if I give too much? 

Penicillin V is normally a safe drug. It is unlikely to cause any problems if you give an extra dose by mistake.

If you think you may have given your child too much  penicillin V, contact your doctor or NHS Direct (0845 4647 in England and Wales; 08454 24 24 24 in Scotland). Have the medicine container or packaging with you if you telephone for advice.

Are there any possible side-effects? 

We use medicines to make our children better or, in this case, to keep them well. Sometimes medicines have other effects that we don’t want (side-effects).

Most children who take penicillin V to prevent infection do not have any side-effects.

Side-effects that you must do something about

If your child gets a skin rash or itching, has problems breathing or seems short of breath or is wheezing, or if their face, throat, lips or tongue start to swell, they may be allergic to penicillin V. Take them to hospital or call an ambulance straight away.

  • If your child has diarrhoea and vomiting, contact your doctor, as they could become very unwell.

Other side-effects you need to know about

  • You may see white patches inside your child’s mouth and throat, and girls may get itching or soreness around the vagina. This is caused by a fungal infection called thrush. If you think your child may have thrush, contact your doctor or pharmacist for advice. 

Can other medicines be given at the same time as penicillin V?

  • You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to. 
  • Penicillin V should not be taken with some common drugs that you get on prescription. Tell your doctor and pharmacist about any other medicines your child is taking before starting penicillin V. 
  • Tell your doctor or pharmacist that your child is taking penicillin V before giving any other medicines. This includes herbal or complementary medicines.

Is there anything else I need to know about penicillin V?

  • Giving antibiotics every day for prevention of illness makes a big difference to the health of children with sickle cell disease and those with asplenia.

Never stop giving penicillin without telling your doctor, even if you think it isn’t doing anything. 

  • Giving antibiotics every day does not weaken your child’s immune system. 
  • Penicillin V provides protection against pneumococcal bacteria, which can causes serious infections in children with sickle cell disease or asplenia. It does not provide protection against other types of infection.
  • Your doctor will probably have recommended that your child has a vaccination to help prevent pneumococcal infection. However, these vaccines do not protect against every type of the pneumococcal bacteria so your child will still need to take penicillin V.
  • If your child develops an infection, your doctor may prescribe a short course of antibiotics to treat this. They will probably tell you to stop giving the penicillin V during this time. You should start giving the penicillin V again on the day after the treatment antibiotics are finished. 

 General advice about medicines

  • Try to give medicines at about the same times each day, to help you remember.
  • Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
  • Make sure the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging.

Where I should keep this medicine? 

  • Keep tablets in a cupboard, away from heat and direct sunlight. 
  • Keep liquid medicine in the fridge.
  • Make sure that children cannot see or reach it.
  • Keep the medicine in the container it came in.

Who to contact for more information 

Your doctor, pharmacist  or nurse will be able to give you more information about penicillin V and about other ways to protect child with sickle cell disease or asplenia from infection.


You can also get useful information from:


Publication Date

12/9/2011

Copyright Disclaimer

Version 1, August 2011. © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: August 2013. 

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.