II. Indications
- Erysipeloid
- Pneumococcal Infections
- Streptococcal Infections
- Acute Necrotizing Ulcerative Gingivitis (ANUG or Vincent's Stomatitis)
- Neurosyphilis
- Congenital Syphilis
- Diphtheria
III. Contraindications
IV. ` Penicillin or Procaine Allergy
- Do NOT inject intravenously
V. Mechanism
- See Penicillin
- See Natural Penicillin for activity spectrum
VI. Precautions
- Largely replaced by other agents due to Antibiotic Resistance
- Listed for historical purposes
VII. Dosing
-
Erysipeloid, Pneumococcal Infections, Streptococcal Infections and ANUG
- Adult (or weight >27 kg): 0.6 to 1 Million Units IM daily
- Child (weight <27 kg)
- Give 0.3 Million Units IM daily OR
- Give 25,000 to 50,000 units/kg/day IM divided in 1-2 doses for moderate infections in age >1 month
-
Diphtheria
- Adult (and weight >10 kg): 0.6 Million units IM every 12 hours until transition to oral Penicillin VK for 14 days
- Child (weight <10 kg): 0.3 Million units IM every 12 hours until transition to oral Penicillin VK for 14 days
-
Neurosyphilis (Adult)
- Give 2.4 Million Units IM daily WITH Probenacid 500 mg every 6 hours for 10 to 14 days
-
Congenital Syphilis (Child)
- Give 50,000 units/kg IM daily for 10 days
VIII. Pharmacokinetics
- Peaks in 4 hours
- Duration: 24 hours
IX. Adverse Effects
- See Penicillin
X. Safety
- Considered safe in pregnancy
- Considered safe in Lactation
XI. Resources
- Procaine Penicillin (DailyMed)
XII. 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]