II. Indications: Penicillin Sensitive Infections (culture-based)
- Pneumococcal Pneumonia
- Pneumococcal Meningitis
- Streptococcal Native Valve Endocarditis
- Group B Streptococcal Meningitis
- Neurosyphilis or Ocular Syphilis
- Congenital Syphilis
- Anthrax
- Diphtheria
III. Contraindications
IV. Mechanism
- See Penicillin
- See Natural Penicillin for activity spectrum
- First Penicillin to be used medically (as of 1941) and the one discovered by Alexander Fleming in 1928
- Fleming observed inhibited growth of Staphylococcus Aureus on an agar plate
- Agar was contaminated with growth of Penicillium mold (Penicillium notatum)
- Penicillin G was ultimately extracted
V. Precautions
- Dose adjustments needed in renal dysfunction
VI. Dosing: Adults
- See Anthrax
-
Pneumococcal Pneumonia (Penicillin Sensitive)
- Give 8 to 12 million units IV every 4 to 6 hours
- Pneumococcal Meningitis (Penicillin Sensitive)
- Give 24 million units IV every 4 to 6 hours
- Streptococcal Native Valve Endocarditis (Streptococcal gallolyticus or viridans, with MIC<= 0.12 mcg/ml)
- Give 12 to 18 million units IV every 4 hours for 4 weeks (may use continuous infusion)
-
Neurosyphilis or Ocular Syphilis
- Give 18 to 24 million units IV every 4 hours for 10 to 14 days (may use continuous infusion)
-
Diphtheria (not FDA approved)
- Give 100,000 to 150,000 units/kg/day IV divided every 6 hours for 14 days
-
Group B Streptococcus Prophylaxis (in GBS positive mothers)
- Start 5 Million Units IV at labor onset or Rupture of Membranes
- Next 2.5 to 3 Million Units IV every 4 hours until delivery
VII. Dosing: Child
- See Anthrax
- Mild to Moderate Infections
- Give 25,000 to 50,000 units/kg/day IV every 6 hours
- Severe Infections (e.g. Pneumococcal Pneumonia or Meningitis)
- Child: Give 250,000 to 400,000 units/kg/day IV divided every 4 to 6 hours
- Newborn: 25,000 to 50,000 units/kg IV every 8 hours
- When age >1 week and weight >2 kg, increase dosing frequency to every 6 hours
- Group B Streptococcal Meningitis
- Age <1 week: Give 250,000 to 400,000 units/kg/day IV divided every 8 hours
- Age >1 week: Give 450,000 to 500,000 units/kg/day IV divided every 4 to 6 hours
-
Congenital Syphilis
- Newborn (<1 month): 50,000 units/kg/dose IV every 12 hours for 10 days
- When age >1 week, increase dosing frequency to every 8 hours
- Child (age >1 month): 50,000 units/kg/dose IV every 4 to 6 hours for 10 days
- Newborn (<1 month): 50,000 units/kg/dose IV every 12 hours for 10 days
-
Diphtheria (not FDA approved)
- Give 100,000 to 150,000 units/kg/day IV divided every 6 hours for 14 days
VIII. Adverse Effects
- See Penicillin
IX. Safety
- Considered safe in pregnancy
- Considered safe in Lactation
X. Resources
- Penicillin G (DailyMed)
XI. References
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 104-7
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Bush (2016) Cold Spring Harb Perspect Med 6(8):a025247 +PMID: 27329032 [PubMed]
- Miller (2002) J Midwifery Womens Health 47(6):426-34 +PMID: 12484664 [PubMed]
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Related Studies
| Definition (NCI) | A broad-spectrum, beta-lactam naturally occurring penicillin antibiotic with antibacterial activity. Penicillin G binds to and inactivates the penicillin binding proteins (PBPs) located inside the bacterial cell wall. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This interrupts bacterial cell wall synthesis and results in the weakening of the bacterial cell wall and eventually causing cell lysis. |
| Definition (MSH) | A penicillin derivative commonly used in the form of its sodium or potassium salts in the treatment of a variety of infections. It is effective against most gram-positive bacteria and against gram-negative cocci. It has also been used as an experimental convulsant because of its actions on GAMMA-AMINOBUTYRIC ACID mediated synaptic transmission. |
| Concepts | Antibiotic (T195) , Organic Chemical (T109) |
| MSH | D010400 |
| SnomedCT | 323389000, 372851008, 78507004 |
| LNC | LP16237-7, MTHU008467 |
| English | Benzylpenicillin, 4-Thia-1-azabicyclo(3.2.0)heptane-2-carboxylic acid, 3,3-dimethyl-7-oxo-6-((phenylacetyl)amino)- (2S-(2alpha,5alpha,6beta))-, Benzylpenicillin(penicillin G), penicillin G, Benzylpenicillin (penicillin G), penicillin G (medication), Penicillin G, Penicillin G [Chemical/Ingredient], benzyl penicillin, penicillin g, g penicillin, penicillin benzyl, benzylpenicillin, Penicillin G (substance), PENICILLIN G, PEN G - Benzylpenicillin, Penicillin G (product), Benzylpenicillin (penicillin G) (substance), Penicillin G, NOS, Benzylpenicillin(penicillin G) (substance) |
| Swedish | Penicillin G |
| Czech | penicilin G |
| Finnish | Bentsyylipenisilliini |
| Russian | BENZILPENITSILLIN, PENITSILLIN G, БЕНЗИЛПЕНИЦИЛЛИН, ПЕНИЦИЛЛИН G |
| Japanese | ベンジルペニシリン, ペニシリンGサスペンション, ペニシリンG |
| French | Pénicilline G, Benzylpénicilline |
| Italian | Benzilpenicillina, Penicillina G |
| Croatian | Not Translated[Penicillin G] |
| Spanish | benzilpenicilina (penicilina G), benzilpenicilina (penicilina G) (sustancia), bencilpenicilina (penicilina G) (sustancia), bencilpenicilina (penicilina G), penicilina G (sustancia), bencilpenicilina, penicilina G (producto), penicilina G, Bencilpenicilina, Penicilina G |
| Polish | Benzylopenicylina, Penicylina G |
| German | Benzylpenicillin, Penicillin G |
| Portuguese | Benzilpenicilina, Penicilina G |
