View source for Penicillin G Benzathine

==General==
*Type: [[Penicillin]], a type of [[Penicillin G]]
*Dosage Forms: IM
*Common Trade Names: Bicillin L-A

==Adult Dosing==
===[[Streptococcal pharyngitis]]===
*1.2 million units IM x 1<ref>CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html</ref>

===[[Syphilis]]===
*Primary, secondary, or latent <1yr
**2.4 million units IM x 1
*Latent >1yr or unknown duration, or tertiary
**2.4 million units IM qWeek x 3 weeks
*Neurosyphilis
**4 million units IV Q4H x10 days

===Rheumatic Fever Prophylaxis, Secondary===
*1.2 million units IM every 4 weeks

===Indications by Disease===
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==Pediatric Dosing==
===Indications by Disease===
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===[[Strep Pharyngitis]]===
*<27kg: 0.6 million units IM x 1<ref>CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html</ref>
*>27kg: 1.2 million units IM x 1<ref>CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html</ref>

===[[Syphilis]]===
*Congenital (<1mo)
**50,000 units/kg IM x 1
**Max: 2.4 million units/dose
**Info: For asymptomatic disease only
*Acquired
**Primary, secondary, or latent <1yr
***50,000 units/kg IM x 1
***Max: 2.4 million units/dose
**Latent >1yr or unknown duration
***50,000 units/kg IM qWeek x 3 weeks
***Max: 2.4 million units/dose

===Rheumatic Fever Prophylaxis, Secondary===
*<27kg: 0.6 million units IM every 4 weeks
*>27kg: 1.2 million units IM every 4 weeks

==Special Populations==
*[[Drug ratings in pregnancy|Pregnancy Rating]]: B
*Lactation: Safe
*Renal Dosing
**Adult
***CrCl 10-50: decrease dose 25%
***CrCl <10: decrease dose 50-80%
***Hemodialysis: give after dialysis without supplement
***Peritoneal Dialysis: decrease dose 50-80%
**Pediatric
***CrCl 10-50: decrease dose 25%
***CrCl <10: decrease dose 50-80%
***Hemodialysis: give supplement
*Hepatic Dosing (Adult & Pediatric)
**No data

==Black Box==
*Do not administer IV or mix with IV solutions (associated with cardiopulmonary arrest)

==Contraindications==
*Allergy to class/drug
*Anaphylactic reaction to [[Beta Lactams]]

===Cautions===
*Non-anaphylactic reaction to [[Beta Lactams]]
*Hypersensitivity to multiple compounds
*Asthma
*Recent antibiotic associated colitis
*[[Seizure]] disorder
*Renal imparement

==Adverse Reactions==
===Serious===
*[[Anaphylaxis]]
*[[Hypersensitivity reaction]]
*Exfoliative dermatitis
*[[Stevens-Johnson syndrome and toxic epidermal necrolysis|Stevens Johnson Syndrome]]
*Superinfection
*[[Clostridium difficile]]
*Jarisch-Herxheimer reaction
*Hemolytic anemia
*Leukopenia
*[[Thrombocytopenia]]
*Nephrotoxicity
*Interstitial nephritis
*[[Seizures]]
*Neuropathy

===Common===
*[[Rash]]
*Urticaria
*[[Fever]]
*Puritis
*Fatigue
*Asthenia
*[[Headache]]
*[[Nausea and vomiting]]
*[[Diarrhea]]
*Injection site reaction
*Sterile [[Incision and drainage|abscess]]
*Elevated creatinine

==Pharmacology==
*Half-life: Unknown
*Metabolism: liver, CYP450
*Excretion: Urine
*Mechanism of Action: Bactericidal

==See Also==
*[[Penicillin G]]
*[[Antibiotics (Main)]]

==References==
<references/>

[[Category:Pharmacology]]
[[Category:ID]]