Allergy. It is cross-linked to all antimicrobial drugs of the penicillin group. This means that if you are once allergic to a penicillin-type antibiotic, for example, ampicillin, it is also dangerous to use any other antibiotic from the penicillin group. Some patients with an allergic reaction to cephalosporins may allergies to penicillins may also occur. It is extremely important to take into account the data of the allergological history, in doubtful cases, to conduct skin tests. Patients with novocaine allergies are not allowed to prescribe benzylpenicillin procaine. If signs of an allergic reaction occur during treatment with penicillins, you should immediately cancel taking any antimicrobial drugs.
Pregnancy. Penicillins, including inhibitor-protected ones, are used in the treatment of pregnant women without any additional restrictions. Negative effects on the female and fetal organisms were not observed, although adequate and strictly controlled studies were not conducted in this regard.
Lactation. Despite the fact that penicillins do not create high concentrations in breast milk, their use in nursing women can lead to sensitization of newborns, the appearance of rashes on the skin and mucous membranes, the development of candidiasis (fungal diseases) and diarrhea.
Pediatrics. In infants and young children may build penicillins in connection with the immaturity of the renal system for excretion. There is an increased risk of toxic effects on the child’s nervous system with the development of seizures. When using oxacillin, transient hematuria (temporary appearance of red blood cells in the urine) may be observed.
Geriatrics. In the elderly, due to age-related changes in kidney function, it may be necessary to adjust the dosage of penicillins.
Impaired kidney function. Due to the fact that penicillins are excreted from the body mainly by the kidneys, and in unchanged form, in case of renal failure, it is necessary to adjust the dosage to avoid excessive accumulation of the drug. In patients with impaired renal function, the risk of hyperkalemia (increased blood potassium levels) increases when using benzylpenicillin.
Pathology of blood clotting. When using carbenicillin, in high concentrations that violate platelet aggregation, the risk of bleeding may increase. To a somewhat lesser extent, this is typical for ureidopenicillins.
Heart failure. Large doses of benzylpenicillin, carbenicillin and other penicillins acting on Pseudomonas aeruginosa can cause the appearance or increase of edema.
Arterial hypertension. Large doses of benzylpenicillin, carbenicillin and to a lesser extent other penicillins acting on Pseudomonas aeruginosa can lead to increased blood pressure and reduced effectiveness of antihypertensive drugs.
Infectious mononucleosis. Ampicillin rash is observed in 75-100 % of patients with infectious mononucleosis.
Dentistry. Long-term use of penicillins, in particular broad-spectrum and inhibitor-protected, can provoke the appearance of oral candidiasis due to a radical change in the composition of the normal microflora. The risk of developing candidiasis is especially high in children and people with weakened immune systems.
Despite the presence of a large percentage of indications for the use of antibiotics, there are also contraindications, so before using them, you should consult your doctor.