Infectious Disease Book


Natural Penicillin

Aka: Natural Penicillin, Penicillin, Benzathine, Bicillin
  1. See Also
    1. Penicillin Allergy
  2. Types: Penicillin Categories
    1. Natural Penicillins (see below)
      1. Penicillin G
      2. Procaine Penicillin G
      3. Penicillin V
      4. Benzathine
    2. Aminopenicillins
      1. Ampicillin or Amoxicillin
      2. Augmentin or Unasyn
    3. Extended Spectrum Penicillin
      1. Ticarcillin
      2. Piperacillin
      3. Carbenicillin
      4. Timentin
    4. Penicillinase-Resistant Semisynthetic Penicillin
      1. Cloxacillin
      2. Dicloxacillin
      3. Methicillin
      4. Nafcillin
      5. Oxacillin
  3. Mechanism: Action
    1. Inhibits cell wall synthesis
  4. Mechanism: Penicillin Resistance mechanisms
    1. Bacterial Production of Beta lactamase
      1. Staphylococcus aureus
      2. Staphylococcus epidermidis
      3. Neisseria gonorrhoeae
      4. Moraxella catarrhalis
    2. Bacterial Alteration in Penicillin-binding Proteins
      1. Streptococcus Pneumoniae (Pneumococcus)
  5. 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)
  6. Dosing: Child
    1. Penicillin G
      1. Standard Dosing
        1. Penicillin G 100-150k U/Kg/day IV/IM divided q4-6h
      2. Group B Streptococcus or Meningitis
        1. Penicillin G 250k-300k U/Kg/day IV/IM divided q4h
      3. HaemophilusInfluenzae Meningitis
        1. Penicillin G 400,000 units/kg/day IV divided q4h
    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 qid
  7. Adverse Effects
    1. Anaphylaxis and other Hypersensitivity Reactions
    2. Nephritis
    3. Hyperkalemia
    4. Seizures
Medication Costs
Penicillin VK (on 6/18/2017 at
Penicillin VK 125mg/5ml susp (100ml) #1 bottle for $4.00 $4.00 each
Penicillin VK 125mg/5ml susp (100ml) #3 bottles for $10.00 $3.33 each
Penicillin VK 250mg #28 tablets for $4.00 $0.14 each
Penicillin VK 250mg #84 tablets for $10.00 $0.12 each
penicillin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing)
PENICILLIN VK 125 MG/5 ML SOLN Generic $0.05 per ml
PENICILLIN VK 250 MG TABLET Generic $0.09 each
PENICILLIN VK 250 MG/5 ML SOLN Generic $0.06 per ml
PENICILLIN VK 500 MG TABLET Generic $0.16 each
bicillin (on 6/1/2017 at Medicaid.Gov Pharmacy Drug pricing)
BICILLIN L-A 1,200,000 UNITS $69.92 per ml
BICILLIN L-A 2,400,000 UNITS $70.82 per ml
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Penicillins (C0030842)

Definition (NCI) Any beta-lactam antibiotic derived from Pencillium fungi with bactericidal activity. Penicillin antibiotics bind to and inactivate penicillin-binding proteins (PBPs) located on the inner membrane of 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, eventually causing cell lysis.
Definition (NCI_NCI-GLOSS) A drug that is used to treat infection. It belongs to the family of drugs called antibiotics.
Definition (MSH) A group of antibiotics that contain 6-aminopenicillanic acid with a side chain attached to the 6-amino group. The penicillin nucleus is the chief structural requirement for biological activity. The side-chain structure determines many of the antibacterial and pharmacological characteristics. (Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed, p1065)
Definition (CSP) group of natural or semisynthetic antibacterial antibiotics that contain 6-aminopenicillanic acid with a side chain attached to the 6-amino group; they exert a bacteriocidal as well as bacteriostatic effect on susceptible bacteria by interfering with the final stages of the synthesis of cell wall peptidoglycan.
Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH D010406
SnomedCT 373270004, 6369005
English Penicillins, Antibiotics, Penicillin, Penicillin Antibiotics, penicillin (medication), penicillin, Penicillins [Chemical/Ingredient], penicillins, penicillin antibiotic, penicillin antibiotics, BETA-LACTAM ANTIBACTERIALS, PENICILLINS, Penicillin, Penicillin -class of antibiotic- (product), Penicillin -class of antibiotic- (substance), Penicillin -class of antibiotic-, Penicillin Antibiotic
Swedish Penicilliner
Czech peniciliny
Finnish Penisilliinit
Japanese ペニシリン系抗生物質, ペニシリン類, 抗生物質-ペニシリン系, ペニシリン
Polish Penicyliny
Spanish penicilina (clase de antibiótico) (producto), penicilina (clase de antibiótico) (sustancia), penicilina (clase de antibiótico), Penicilinas, Antibióticos Penicilinos
French Pénicillines
German Antibiotika, Penicillin-, Penicilline
Italian Penicilline
Portuguese Antibióticos Penicilina, Penicilinas
Derived from the NIH UMLS (Unified Medical Language System)

benzathine (C0053153)

Concepts Organic Chemical (T109)
MSH C010044
English benzathine, N,N'-dibenzylethylenediamine
Derived from the NIH UMLS (Unified Medical Language System)

Natural penicillin (C0304323)

Concepts Antibiotic (T195) , Organic Chemical (T109)
SnomedCT 86536001, 373291007
English penicillin natural, natural penicillin, Natural penicillin (product), Natural penicillin (substance), Natural penicillin, Natural penicillin, NOS
Spanish penicilina natural (producto), penicilina natural (sustancia), penicilina natural
Derived from the NIH UMLS (Unified Medical Language System)

Bicillin (C0729074)

Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH D010401
English bicillin, Bicillin
Czech Bicillin
Derived from the NIH UMLS (Unified Medical Language System)

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