BENZYLPENICILLIN = PENICILLIN G injectable

Therapeutic action

• Short-acting penicillin antibacterial

Indications

• Severe leptospirosis, neurosyphilis
• Congenital syphilis (presence of clinical signs in the neonate and lack of adequate treatment in the mother)

Forms and strengths, route of administration

• Powder for injection in vials of:
  • 1 MIU (600 mg), to be dissolved in 2 ml of water for injection or 0.9% sodium chloride
  • 5 MIU (3 g), to be dissolved in 5 ml of water for injection or 0.9% sodium chloride
• For IM injection or slow IV injection through an infusion tube (3 to 5 minutes) or infusion (60 minutes) in 0.9% sodium chloride or 5% glucose.

Dosage

Severe leptospirosis

• Child: 50 000 IU (30 mg)/kg (max. 2 MIU or 1200 mg) by IV injection every 6 hours
• Adult: 1 to 2 MIU (600 to 1200 mg) by IV injection every 6 hours

Neurosyphilis

• Adult: 2 to 4 MIU (1200 to 2400 mg) by IV injection every 4 hours

Congenital syphilis

• 50 000 IU (30 mg)/kg by IV injection every 12 hours from D1 to D7, then
• 50 000 IU (30 mg)/kg by IV injection every 8 hours from D8 to D10

Duration

• Severe leptospirosis: 7 days
• Neurosyphilis: 14 days
• Congenital syphilis: 10 days

Contra-indications, adverse effects, precautions

• Do not administer to penicillin-allergic patients.
• Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur) and renal impairment (reduce dosage in patients with neurosyphilis).
• May cause:
  • gastroinstestinal disturbances, pain at injection site, anaemia, allergic reactions sometimes severe;
  • Jarisch-Herxheimer reaction (fever, chills, myalgia, tachycardia) in patients with syphilis;
  • convulsions in the event of rapid IV injection, high dosages or renal impairment.
• Do not combine with methotrexate.
• Pregnancy: no contra-indication
• Breast-feeding: no contra-indication

Remarks

• Do not confuse short-acting benzylpenicillin, administered several times a day by IV route, with long-acting penicillins (benzathine benzylpenicillin and procaine benzylpenicillin) administered by IM route only.
• Do not mix with other drugs in the same syringe or infusion.

Storage