Penicillin G

C difficile risk
Low
Oral Bioavailability
N/A
Cost
$8.40/day $92.22 IM

Dosing

12-24 million units/day IV in 6 divided doses

Do not use short-acting IV formulation for single dose treatment of syphilis. This requires the long-acting 2.4 mu pen g benzathine formulation. May be single dose or multiple weekly doses depending on stage of syphilis.

ID consultation recommended

eGFR 0 - 10eGFR 10 - 50eGFR > 500.5-4MU IV q12h
20-50% of dose for normal renal function0.5-4MU IV q8h
75% of dose for normal renal function0.5-4MU IV q4-6h
Normal recommended maximum dose: 24 mU/day

Up to 2 million units IV q4-6h for serious infections

For mild-to-moderate infections, administer 0.5 to 1 million units every 4 to 6 hours or 1 to 2 million units every 8 to 12 hours

Administer after dialysis on HD days.

Pharmacist review recommended.

2 million units IV q4-6h

Varies depending on type of renal replacement therapy

Pharmacist consult recommended

General Information

Therapy of Streptococcal and other documented susceptible infections.

  • Allergy/rash (immediate or delayed)

  • Seizures

  • Cytopenias

  • Eosinophilia

  • Interstitial nephritis

  • Abnormal liver enzymes

  • Serum sickness

Pen G for IV infusion is not the same as the long acting benzathine IM formualtion. Used for syphilis; double check when ordering or dispensing

IV Administration
Dilute in 100 mL D5W or NS and administer over 30-60 min. (60 min for 4 or 5 mU doses)

EH Prescribing Restrictions
None

Community IV Formulary (Metro Area)
YES

Antimicrobial class: Penicillin

Pregnancy category: B

Average serum half life: 1 hour

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Moderate

Biliary penetration: Therapeutic