Penicillin

What are the types of penicillin?

Two of the major differences between the types of penicillin are the way they’re made and what kind of bacteria they’re effective against. Types of penicillin include:

• Natural penicillins. Natural penicillins are found in the world around us (they aren’t made by people). Scientists isolate (purify) just the penicillin from where it’s found to make it into medications.
• Semi-synthetic penicillins. Scientists alter penicillin’s natural form to make more effective antibiotics. These are called semi-synthetic penicillins. They include penicillinase-resistant penicillins, aminopenicillins and extended-spectrum penicillins.
• Combination medications. Penicillins are often combined with other medications into one drug to help them work better.

Natural penicillins

Penicillin G and penicillin V (also known as penicillin V potassium) are natural penicillins. Providers use natural penicillins to treat a range of infections, including strep throat, syphilis and Lyme disease. Penicillin G comes in IV form. Penicillin V you can take by mouth.

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Semi-synthetic penicillins

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Semi-synthetic penicillins include:

• Penicillinase-resistant penicillins. Nafcillin, oxacillin and dicloxacillin are penicillinase-resistant penicillins. They come in both IV and pill form and are often used to treat staph infections. Methicillin, which is rarely used anymore, is also a penicillinase-resistant penicillin.
• Aminopenicillins. Amoxicillin and ampicillin are aminopenicillins. Amoxicillin is one of the most commonly used penicillins. Providers use it to treat ear infections, UTIs, pneumonia and other common infections. It comes in a pill or liquid you can swallow. Ampicillin comes in pill or IV form.
• Extended-spectrum penicillins. Piperacillin is an extended-spectrum penicillin. Providers use it for hard-to-treat infections, like Pseudomonas aeruginosa. Other extended-spectrum penicillins, like carbenicillin and ticarcillin, are discontinued in the U.S.

Combination penicillins

Penicillin can be combined with other drugs, called beta-lactamase inhibitors, to help them work better. Beta-lactamase inhibitors work by preventing bacterial enzymes (beta-lactamases) from destroying the antibiotic. Some penicillin/beta-lactamase inhibitor combinations include:

• Augmentin® (amoxicillin and clavulanic acid).
• Unasyn® (ampicillin and sulbactam).
• Zosyn® (piperacillin and tazobactam).

How does penicillin work?

Penicillin works by attaching to the wall of bacteria cells. It damages the cell wall and eventually destroys the bacteria.

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Over time, bacteria have developed resistance to natural penicillins. This means that certain types of bacteria can prevent antibiotics from damaging their cells. This has happened many times since penicillin’s first use. Each time, scientists developed new antibiotics that worked in the same ways as natural penicillin — by attaching to the cell wall — but had methods for avoiding antibiotic resistance.

Some bacteria, like MRSA (methicillin-resistant Staphylococcus aureus), resist all types of penicillins. This can make them very hard to treat. Scientists have developed antibiotics that work in different ways to try to treat these infections.

How long will I need penicillin?

Providers usually prescribe penicillin medications for one to three weeks, depending on which infection you have. It’s important to take penicillins as prescribed. Take them on schedule until you finish the entire course, even if you feel better.

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