septicaemia, pneumonia, meningitis, bilary tract infections, peritonitis, and urinary tract infections.

MOA: Bactericidal; interfere with bacterial cell wall peptidoglycan synthesis by binding to penicillin-binding proteins, eventually leading to cell lysis and death.

can be narrow or braod spectrum, can be for G+ve and G-ve

Side Effects

• well tolerated
• Common side-effects include diarrhoea, nausea, skin rash, pain and inflammation at injection site (less common with benzylpenicillin, compared with other penicillins).
• Less common side effects include vomiting, and Clostridium difficile infection.
• One of the most important side effects of penicillins is hypersensitivity, which causes rash and, occasionally anaphylaxis, which can be fatal. Patients allergic to one penicillin will generally be allergic to all as the hypersensitivity is related to the structure of the penicillin – specifically the beta-lactam ring.
• renally cleared - monitor renal function

Ampicillin

used in G-ve and enterococci, but destroyed with beta lactamase producing organisms (Kleb)

used in combo with gentamicin (for gram -ve) common empiracal therapy for UTI.

Treatment of choice for enterococcal UTI

IV, 2g 6hrly