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Procaine Penicillin and Benzathine Penicillin

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Procaine Penicillin and Benzathine Penicillin, Bicillin CR

  • See Also
  1. Natural Penicillin
  2. Penicillin
  • Indications
  1. Scarlet Fever
  2. Group A Streptococcal Soft Tissue Infection
  3. Pneumococcal Pneumonia
  • Contraindications
  • ` Penicillin or Procaine Allergy
  1. Do NOT inject intravenously (potentially lethal)
  2. Do NOT use for Syphilis (use Bicillin LA instead)
  3. Do NOT use for Meningitis (use Penicillin G instead or broader spectrum antibiotics)
  4. Avoid for Streptococcal Pharyngitis (use Bicillin LA instead)
  • Mechanism
  1. See Penicillin
  2. Semisynthetic, long-acting benzathine salt of Penicillin G
  3. See Natural Penicillin for activity spectrum
  4. Bicillin LA is typically preferred instead of Bicillin CR (based on activity curves)
  • Dosing
  1. General
    1. Inject deep IM into upper outer buttock, or in children, inject into the mid-lateral thigh
  2. Scarlet Fever or Group A Streptococcal Soft Tissue Infection
    1. Adult: Give 2.4 Million Units IM for 1 dose
    2. Child
      1. Weight <13.6 Kg: 600,000 units IM for 1 dose
      2. Weight 13.6 to 27 kg: 900,000 to 1.2 Million Units IM for 1 dose
      3. Weight >27 kg: 2.4 Million Units IM for 1 dose
  3. Pneumococcal Pneumonia
    1. Adult: Give 1.2 Million Units IM every 2 to 3 days until affebrile for 48 hours
    2. Child: Give 600,000 Units IM every 2 to 3 days until affebrile for 48 hours
  • Adverse Effects
  1. See Penicillin
  • Safety
  1. Considered safe in pregnancy
  2. Considered safe in Lactation
  • Resources
  1. Procaine Penicillin and Benzathine Penicillin (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ba7b9199-4710-4189-a85d-77ed75befe4d
  • References
  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 104-7
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  3. Bush (2016) Cold Spring Harb Perspect Med 6(8):a025247 +PMID: 27329032 [PubMed]
  4. Miller (2002) J Midwifery Womens Health 47(6):426-34 +PMID: 12484664 [PubMed]