III. Contraindications

  1. Do NOT inject intravenously (potentially lethal)
  2. Not adequate for Neurosyphilis treatment

IV. Mechanism

  1. See Penicillin
  2. Semisynthetic, long-acting benzathine salt of Penicillin G
  3. See Natural Penicillin for activity spectrum

V. Dosing

  1. General
    1. Inject deep IM into upper outer buttock, or in children, inject into the mid-lateral thigh
  2. Group A Streptococcal Pharyngitis
    1. Weight <27 kg: 0.6 Million Units IM for 1 dose
    2. Weight >27 kg: 1.2 Million Units IM for 1 dose
  3. Syphilis
    1. Adult: 2.4 Million Units IM
    2. Child: 50,000 Units/kg up to 2.4 Million Units IM
    3. Timing
      1. Primary, Secondary or early Latent Syphilis: Give single dose at diagnosis
      2. Tertiary or late Latent Syphilis: Repeat dose weekly for a total of 3 weeks
        1. Not adequate coverage for Neurosyphilis
  4. Diphtheria Prophylaxis and Carrier Treatment
    1. Weight <30 kg: 0.6 Million Units IM for 1 dose
    2. Weight >30 kg: 1.2 Million Units IM for 1 dose

VI. Adverse Effects

VII. Safety

  1. Considered safe in pregnancy
  2. Considered safe in Lactation

IX. References

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Related Studies

Ontology: penicillin G benzathine (C0030829)

Definition (NCI) The long-acting benzathine salt form of penicillin G, a broad-spectrum penicillin antibiotic. Penicillin G benzathine binds to penicillin binding proteins (PBP), the enzymes that catalyze the synthesis of peptidoglycan, a critical component of the bacterial cell wall. This leads to the interruption of cell wall synthesis, consequently leading to bacterial cell growth inhibition and cell lysis.
Definition (MSH) Semisynthetic antibiotic prepared by combining the sodium salt of penicillin G with N,N'-dibenzylethylenediamine.
Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH D010401
SnomedCT 323404007, 391825001, 75247008
LNC LP16332-6, MTHU019820
English Benzathine Penicillin, Penicillin, Benzathine, 4-Thia-1-azabicyclo(3.2.0)heptane-2-carboxylic acid, 3,3-dimethyl-7-oxo-6-((phenylacetyl)amino)- (2S-(2alpha,5alpha,6beta))-, compd. with N,N'-bis(phenylmethyl)-1,2-ethanediamine (2:1), Benzathine Benzylpenicillin, Benzathine, Penicillin G, Benzylpenicillin, Benzathine, G Benzathine, Penicillin, penicillin G benzathine (medication), penicillin G benzathine, Penicillin G Benzathine, PENICILLIN G BENZATHINE, Penicillin G Benzathine [Chemical/Ingredient], benzathine penicillin g, penicillin benzathine, penicillin g benzathine, benzathine penicillin, benzathine benzylpenicillin, Benzathine penicillin - chemical (substance), Benzathine penicillin - chemical, Benzathine benzylpenicillin, Benzathine penicillin, Benzathine penicillin G, Dibenzylethylenediamine benzylpenicillin, Penicillin G benzathine, Penicillin G benzathine (substance), Benzathine penicillin (product), Benzylpenicillin benzathine, Benzathine penicillin (substance)
Swedish Penicillin G, bensatin
Czech benzathin-penicilin G
Finnish Bentsatinipenisilliini
Russian BITSILLIN, BENZATIN PENITSILLIN, PENITSILLIN G, BENZATIN, PENITSILLINA G BENZATIN, ПЕНИЦИЛЛИНА G БЕНЗАТИН, БЕНЗАТИН ПЕНИЦИЛЛИН, БИЦИЛЛИН, ПЕНИЦИЛЛИН G, БЕНЗАТИН
Japanese ペニシリンG-ベンザチン, ベンジルペニシリンベンザチン水和物, ベンザチンペニシリン, ベンジルペニシリンベンザチン, バイシリン, バイシリンG, ペニシリンGベンザチン, ベンザチンペニシリンG, ジベンジルエチレンジアミンペニシリンG
French Benzathine benzylpénicilline, Pénicilline G benzathine, Benzéthacil
Polish Debecylina, Penicylina benzatynowa
Spanish penicilina benzatínica (sustancia), bencilpenicilina dibenciletilendiamina, penicilina G benzatínica (sustancia), penicilina G benzatínica, penicilina benzatínica (producto), penicilina benzatínica, Penicilina G Benzatina, Penicilina Benzatínica
German Benzathin-Penicillin, Penicillin G, Benzathin-
Italian Penicillina G benzatina
Portuguese Penicilina Benzatina, Penicilina G Benzatina

Ontology: Bicillin (C0729074)

Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH D010401
English bicillin, Bicillin
Czech Bicillin