Penicillin G

C. difficile 위험도


GAS (S. pyogenes) pharyngitisEarly syphilisLate latent syphilisRheumatic fever prophylaxis1.2 mu IM 1 dose2.4 mu IM 1 dose2.4 mu IM q1w 3 times1.2 mu IM q4w

Streptococcal bacteremia, endocarditis, pneumonia, empyema, meningitisStaphylococcal bacteremia, endocarditis, pneumonia, empyema, meningitisAnthraxCervicofacial actinomycosisThoracoabdominal actinomycosisClostridial infection (botulism, gas gangrene, tetanus)DiphtheriaErysipelothrix endocarditisFusospirochetosisListerial meningitisListerial endocarditisPasteurella bacteremia, meningitis12-24 mu IV #4-65-24 mu IV #4-6≥8 mu IV #41-6 mu IV #4-610-20 mu IV #4-620 mu IV #4-62-3 mu IV #4-6 x10-12d12-20 mu IV #4-6 x4-6w5-10 mu IV #4-615-20 mu IV #4-6 x2w15-20 mu IV #4-6 x4w4-6 mu IV #4-6 x2w

Rat-bite fever 12-20 mu IV #4-6 x3-4w

Disseminated gonococcal infection(meningitis, endocarditis, arthritis) 10 mu IV #4-6

Neurosyphilis 12-24 mu IV #6 x10-14d

Meningococcal meningitis, bacteremia 24 mu IV #12

GAS (S. pyogenes) pharyngitis

  • BW ≤27 kg 300,000-600,000 u IM 1 dose

  • BW >27 kg 900,000 u IM 1 dose

Congenital syphilis

  • Age <2y 50,000 u/kg IM 1 dose

  • Age ≥2y Refer to adult dose

Rheumatic fever prophylaxis

  • BW ≤27 kg 600,000 u IM q4w

  • BW >27 kg 1.2 mu IM q4w

Streptococcal or meningococcal pneumonia, endocarditis 150,000-300,000 u/kg IV #4-6

Pneumococcal or meningococcal meningitis 250,000 u/kg IV #6 x7-14d (max 12-20 mu/d)

Gonococcal arthritis 100,000 u/kg IV #6 x7-10d

Gonococcal meningitis 250,000 u/kg IV #6 x10-14d

Gonococcal endocarditis 250,000 u/kg IV #6 x4w

Congenital syphilis, neurosyphilis 200,000-300,000 u/kg IV #4-6 x10-14d

Diphtheria 150,000-250,000 u/kg IV #4 x7-10d

Rat-bite fever 150,000-250,000 u/kg IV #6 x4w

If BW ≥45 kg & gonococcal arthritis, meningitis, endocarditis, refer to adult dose

No dose adjustment

No dose adjustment

CrCl ≥10CrCl <10No dose adjustmentRecommended dose IV 1 dose, then 50% recommended dose IV q8-12h

General Information

Actinomycotic infection Anthrax Bacteremia, gram-negative Bacterial meningitis Clostridial infection; adjunct Congenital syphilis Diphtheria due to Corynebacterium diphtheriae; treatment and prophylaxis Disseminated gonococcal infection Empyema Fusospirochetosis Infective endocarditis Neurosyphilis Pasteurella infection Pericarditis Pneumonia Rat bite fever Sepsis

During prolong therapy, monitor electrolytes, hepatic and renal functions, hematologic status, cardiac and vascular status.

Perform serologic test for syphilis before initiating therapy for gonococcal infection.

Clinical and serologic follow-up for syphilis treated with penicillin.

  • Allergy/rash (immediate or delayed)

  • Seizures

  • Cytopenias

  • Eosinophilia

  • Interstitial nephritis

  • Abnormal liver enzymes

  • Serum sickness

  • Tetracyclines - decreased antibacterial effectiveness

  • Warfarin - increased risk of bleeding

  • Methotrexate - increased risk of toxicity

  • Seizure agents - reduced seizure threshold

Antimicrobial class: Penicillin

Pregnancy category: B

Average serum half life: 1 hour

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Moderate

Biliary penetration: Therapeutic

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