Penicillin G Benzathine

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General

Adult Dosing

Streptococcal pharyngitis

  • 1.2 million units IM x 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

Pediatric Dosing

Strep Pharyngitis

  • <27kg: 0.6 million units IM x 1
  • >27kg: 1.2 million units IM x 1

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

  • 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

Common

Pharmacology

  • Half-life: Unknown
  • Metabolism: liver, CYP450
  • Excretion: Urine
  • Mechanism of Action: Bactericidal

See Also

References