Penicillin G Benzathine: Difference between revisions
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===[[Strep Pharyngitis]]=== | ===[[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]]=== | ===[[Syphilis]]=== | ||
* | *Congenital (<1mo) | ||
**50,000 units/kg IM x 1 | **50,000 units/kg IM x 1 | ||
**Max: 2.4 million units/dose | **Max: 2.4 million units/dose | ||
**Info: For asymptomatic disease only | **Info: For asymptomatic disease only | ||
* | *Acquired | ||
**Primary, secondary, or latent <1yr | **Primary, secondary, or latent <1yr | ||
***50,000 units/kg IM x 1 | ***50,000 units/kg IM x 1 | ||
| Line 62: | Line 62: | ||
===Rheumatic Fever Prophylaxis, Secondary=== | ===Rheumatic Fever Prophylaxis, Secondary=== | ||
* | *<27kg: 0.6 million units IM every 4 weeks | ||
* | *>27kg: 1.2 million units IM every 4 weeks | ||
==Special Populations== | ==Special Populations== | ||
Latest revision as of 09:13, 22 March 2026
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[1]
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
| Disease | Dose | Context |
|---|---|---|
| Streptococcal pharyngitis | <27 kg: 0.6 million units; ≥27 kg: 1.2 million units IM x 1 | Penicillin Options |
| Syphilis | 2.4 million units IM x 1 | Early Stage |
| Syphilis | 2.4 million units IM weekly x 3 weeks | Late Stage |
Pediatric Dosing
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| Streptococcal pharyngitis | <27kg: 600,000 units IM x 1; >27kg: 1.2 million units IM x 1 | Pediatric First Line |
| Syphilis | 50,000 units/kg IM x 1 | Congenital, maternal treatment adequate |
| Syphilis | 50,000 units/kg IM x 1 (max 2.4 million units) | Pediatric Early Stage |
Strep Pharyngitis
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
- Primary, secondary, or latent <1yr
Rheumatic Fever Prophylaxis, Secondary
- <27kg: 0.6 million units IM every 4 weeks
- >27kg: 1.2 million units IM every 4 weeks
Special Populations
- 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
- Adult
- 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
- 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 abscess
- Elevated creatinine
Pharmacology
- Half-life: Unknown
- Metabolism: liver, CYP450
- Excretion: Urine
- Mechanism of Action: Bactericidal
See Also
References
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html
- ↑ CDC Website, accessed 2026-28-01. https://www.cdc.gov/group-a-strep/hcp/clinical-guidance/strep-throat.html