II. Indications
III. Contraindications
- Do NOT inject intravenously (potentially lethal)
- Not adequate for Neurosyphilis treatment
IV. Mechanism
- See Penicillin
- Semisynthetic, long-acting benzathine salt of Penicillin G
- See Natural Penicillin for activity spectrum
V. Dosing
-
General
- Inject deep IM into upper outer buttock, or in children, inject into the mid-lateral thigh
-
Group A Streptococcal Pharyngitis
- Weight <27 kg: 0.6 Million Units IM for 1 dose
- Weight >27 kg: 1.2 Million Units IM for 1 dose
-
Syphilis
- Adult: 2.4 Million Units IM
- Child: 50,000 Units/kg up to 2.4 Million Units IM
- Timing
- Primary, Secondary or early Latent Syphilis: Give single dose at diagnosis
- Tertiary or late Latent Syphilis: Repeat dose weekly for a total of 3 weeks
- Not adequate coverage for Neurosyphilis
-
Diphtheria Prophylaxis and Carrier Treatment
- Weight <30 kg: 0.6 Million Units IM for 1 dose
- Weight >30 kg: 1.2 Million Units IM for 1 dose
VI. Adverse Effects
- See Penicillin
VII. Safety
- Considered safe in pregnancy
- Considered safe in Lactation
VIII. Resources
- Penicillin G Benzathine (DailyMed)
IX. 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]