Which of the following statements is true when educating clients about penicillin therapy?
A. The client must take the medication at evenly spaced intervals.
B. The client may save leftover medication for a future illness.
C. If signs of an allergic reaction, continue the medication and notify the physician.
D. Clients taking oral contraceptives must be cautioned to use an alternate form of birth control while being treated with penicillin.
Correct Answer: D. Clients taking oral contraceptives must be cautioned to use an alternate form of birth control while being treated with penicillin.
Penicillin will reduce the effectiveness of birth control pills. Numerous antibiotics have been implicated in causing oral contraceptive failure by means of interfering with the enterohepatic recirculation of ethinylestradiol. The two groups of antibiotics most commonly involved in contraceptive failures are tetracyclines and penicillins, namely ampicillin.
Option A: The safety of penicillin and penicillin derivatives when administered either intramuscularly, intravenously, or orally for extended periods of time (beyond the usual duration of use) can be extrapolated from multiple published studies. A review of the medical literature reveals studies in which such drugs have been used therapeutically for extended treatment durations. This includes studies of the treatment of recurrent acute otitis media, endocarditis, salmonella infections, prophylaxis of at-risk populations (asplenic children, young children with sickle cell disease, patients with prior rheumatic fever), and the long term treatment of certain types of Lyme disease.
Option B: 159 patients were treated with 200,000 units orally BID, 143 were treated with 200,000 units orally BID-TID, and 9 patients were treated with an unspecified dose. In these studies, the safety and tolerability of the regimen is summarized by such descriptions as the treatment was “generally well tolerated.” There were no reports in any of these studies of adverse events including serious adverse events or adverse events requiring treatment.
Option C: Although there are no specific studies that directly assess the safety of these antibiotics when given over an extended period of time, there is a significant amount of information that supports the safety of such therapy. Despite very wide usage for many years, no reports were found in the literature which described specific adverse events related to long term use of penicillin or amoxicillin.