Natural Penicillin

Aka: Natural Penicillin, First Generation Penicillin

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II. Indications: Antibacterial Activity Spectrum

  1. General Spectrum
    1. Gram Positive Cocci
    2. Gram Positive bacilli
    3. Spirochetes
    4. Gram Negative Coccobacilli
    5. Anaerobic Bacteria
  2. Penicillin drug of choice in:
    1. Gram Positive Cocci
      1. Group A Streptococcus (Streptococcus Pyogenes)
      2. Group B Streptococcus (Streptococcus agalactiae)
      3. Streptococcus Pneumoniae
    2. Spirochetes
      1. Treponema pallidum (Syphilis)

III. Mechanism

  1. See Penicillin

IV. Medications: Natural Penicillins (First Generation)

  1. Original Natural Penicillins
    1. Penicillin V or Phenoxymethylpenicillin (oral)
    2. Penicillin G or Benzylpenicillin (IV)
  2. Semisynthetic Penicillins derived from Penicillin G for long duration after IM Injection
    1. Procaine Penicillin G
    2. Benzathine Penicillin G (Bicillin LA)
    3. Procaine Penicillin and Benzathine Penicillin (Bicillin CR)

V. Dosing: First Generation Penicillins (Natural Penicillins)

  1. Penicillin G
    1. Standard Dosing
      1. Penicillin G 100-150k U/Kg/day IV/IM divided every 4 to 6 hours
    2. Group B Streptococcus or Meningitis
      1. Penicillin G 250k-300k U/Kg/day IV/IM divided every 4 hours
    3. Haemophilus Influenzae Meningitis
      1. Penicillin G 400,000 units/kg/day IV divided every 4 hours
  2. Benzathine Penicillin (Bicillin LA)
    1. Weight <27 kg: 0.3 to 0.6 Million Units IM for 1 dose
    2. Weight >27 kg: 0.9 to 1.2 Million Units IM for 1 dose
  3. Penicillin V (Pen-Vee K)
    1. Supplied: 125 or 250 mg/5ml elixir
    2. Dosing: 25-50 mg/kg/day divided four times daily (up to 250 to 500 mg every 6 hours)

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