Specific uses for phenoxymethylpenicillin include:
* Infections caused by Streptococcus pyogenes
** Tonsillitis
** Pharyngitis
** Skin infections
* Anthrax (mild uncomplicated infections)
* Lyme disease (early stage in pregnant women or young children)
* Rheumatic fever (primary and secondary prophylaxis)
* Streptococcal skin infections
* Spleen disorders (pneumococcal infection prophylaxis)
* Initial treatment for dental abscesses
* Moderate-to-severe gingivitis (with metronidazole)
* Avulsion injuries of teeth (as an alternative to tetracycline)
* Blood infection prophylaxis in children with sickle cell disease.
Penicillin V is sometimes used in the treatment of odontogenic infections.
It is less active than benzylpenicillin (penicillin G) against Gram-negative bacteria. Phenoxymethylpenicillin has a range of antimicrobial activity against Gram-positive bacteria that is similar to that of benzylpenicillin and a similar mode of action, but it is substantially less active than benzylpenicillin against Gram-negative bacteria.
Phenoxymethylpenicillin is more acid-stable than benzylpenicillin, which allows it to be given orally.
Phenoxymethylpenicillin is usually used only for the treatment of mild to moderate infections, and not for severe or deep-seated infections since absorption can be unpredictable. Except for the treatment or prevention of infection with Streptococcus pyogenes (which is uniformly sensitive to penicillin), therapy should be guided by bacteriological studies (including sensitivity tests) and by clinical response. People treated initially with parenteral benzylpenicillin may continue treatment with phenoxymethylpenicillin by mouth once a satisfactory response has been obtained.
It is not active against beta-lactamase-producing bacteria, which include many strains of Staphylococci.