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benzathine penicillin (Bicillin L-A)

Tradename: Bicillin L-A. 1st generation penicillin. Indications: 1) active against most gram positive organisms, especially Streptococcus species 2) active against Neisseria gonorrhoeae 3) active against some anaerobes 4) active against some spirochetes 5) treatment of mild to moderately severe infections 6) prophylaxis against susceptible organisms Dosage: 1) adults: a) group A streptococcal respiratory tract infection: 1.2 x 10E6 U IM as a single dose b) prophylaxis of recurrent rheumatic fever: 1.2 x 10E6 U IM every 3-4 weeks, or 600,000 U IM every 2 weeks c) early syphilis: 2.4 x 10E6 U IM as a single dose d) syphilis of more than 1 year duration: 2.4 x 10E6 U IM weekly for 3 doses 2) infants & children a) group A streptococcal respiratory tract infection: 25,000 U/kg IM as a single dose; maximum 1.2 x 10E6 U b) prophylaxis of recurrent rheumatic fever: 25,000 U/kg IM every 3-4 weeks; maximum 1.2 x 10E6 U c) early syphilis: 50,000 U/kg IM as a single dose; maximum 2.4 x 10E6 U d) syphilis of more than 1 year duration: 50,000 U/kg IM weekly for 3 doses; maximum 2.4 x 10E6 U/dose 3) neonates > 1200 g: 50,000 U IM as a single dose Injection: 600,000 U/mL (2 mL) Pharmacokinetics: 1) slowly absorbed following IM administration 2) time to peak serum concentration within 12-24 hours Adverse effects: 1) not common (1-10%) - local pain 2) uncommon (< 1%) - thrombophlebitis, convulsions, confusion, drowsiness, fever, rash, electrolyte imbalance, hemolytic anemia, positive direct antiglobulin (Coomb's) test (DAT), myoclonus, acute interstitial nephritis, Jarisch- Herxheimer reaction, hypersensitivity reaction, anaphylaxis

Interactions

drug interactions

General

penicillin G

Properties

MISC-INFO: elimination route KIDNEY pregnancy-category B safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998

Component-of

Bicillin CR