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Phenoxymethylpenicillin Versus Amoxicillin for Infections in Ambulatory Care: A Systematic Review

Philip Lawrence Skarpeid1, Sigurd Høye2

  • 1Faculty of Medicine, University of Oslo, 0318 Oslo, Norway. pls@live.no.

Antibiotics (Basel, Switzerland)
|September 6, 2018
PubMed

Insights

Phenoxymethylpenicillin and amoxicillin show similar clinical effects for most respiratory tract infections (RTIs). Non-Scandinavian countries could consider narrow-spectrum phenoxymethylpenicillin for RTIs due to its advantages.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • General Practice

Background:

  • Antibiotics are frequently prescribed in primary care, particularly for respiratory tract infections (RTIs).
  • Phenoxymethylpenicillin (narrow-spectrum) is standard for RTIs in Scandinavia, while amoxicillin (broader-spectrum) is common elsewhere in Europe.

Purpose of the Study:

  • To review and compare the clinical effectiveness of phenoxymethylpenicillin versus amoxicillin for infections managed in ambulatory care settings.
  • To inform antibiotic prescribing practices for RTIs.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) comparing phenoxymethylpenicillin and amoxicillin.
  • Searches conducted in PubMed/Medline and Embase.
  • Risk of bias assessed using the Norwegian Knowledge Centre for the Health Services' checklist.

Main Results:

  • No significant differences in clinical efficacy were found for acute sinusitis, GAS tonsillitis, and Lyme borreliosis across 18 RCTs.
  • Amoxicillin showed superiority in one RCT for community-acquired pneumonia.
  • Results were conflicting for acute otitis media in two RCTs.

Conclusions:

  • Phenoxymethylpenicillin may be a suitable first-choice antibiotic for RTIs in non-Scandinavian countries due to its narrower spectrum.
  • Further research is needed on the comparative efficacy of phenoxymethylpenicillin and amoxicillin for acute otitis and lower RTIs.
Keywords:
ambulatory careamoxicillinantibioticsphenoxymethylpenicillinprimary health careresistancetreatment

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