Penicillin G

See Anthrax
Pneumococcal Pneumonia (Penicillin Sensitive)
1. Give 8 to 12 million units IV every 4 to 6 hours
Pneumococcal Meningitis (Penicillin Sensitive)
1. Give 24 million units IV every 4 to 6 hours
Streptococcal Native Valve Endocarditis (Streptococcal gallolyticus or viridans, with MIC<= 0.12 mcg/ml)
1. Give 12 to 18 million units IV every 4 hours for 4 weeks (may use continuous infusion)
Neurosyphilis or Ocular Syphilis
1. Give 18 to 24 million units IV every 4 hours for 10 to 14 days (may use continuous infusion)
Diphtheria (not FDA approved)
1. 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)
1. Start 5 Million Units IV at labor onset or Rupture of Membranes
2. Next 2.5 to 3 Million Units IV every 4 hours until delivery

See Anthrax
Mild to Moderate Infections
1. Give 25,000 to 50,000 units/kg/day IV every 6 hours
Severe Infections (e.g. Pneumococcal Pneumonia or Meningitis)
1. Child: Give 250,000 to 400,000 units/kg/day IV divided every 4 to 6 hours
2. Newborn: 25,000 to 50,000 units/kg IV every 8 hours
  1. When age >1 week and weight >2 kg, increase dosing frequency to every 6 hours
Group B Streptococcal Meningitis
1. Age <1 week: Give 250,000 to 400,000 units/kg/day IV divided every 8 hours
2. Age >1 week: Give 450,000 to 500,000 units/kg/day IV divided every 4 to 6 hours
Congenital Syphilis
1. Newborn (<1 month): 50,000 units/kg/dose IV every 12 hours for 10 days
  1. When age >1 week, increase dosing frequency to every 8 hours
2. Child (age >1 month): 50,000 units/kg/dose IV every 4 to 6 hours for 10 days
Diphtheria (not FDA approved)
1. Give 100,000 to 150,000 units/kg/day IV divided every 6 hours for 14 days