Penicillin G

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

$$$

Dosing

20- 24 million units q24h (24-hr infusion)

Latent or secondary Syphilis
2.4 million units IM weekly x 3 injections

Except in the case of hemodialysis, administration should be as a continuous infusion over 24 hours

CrCl >50 mL/minCrCl 10 - 50 mL/minCrCl <10 mL/min (ESRD not on HD)Dialysis (HD)Dialysis (CRRT)18-24 MU IV Q24h 8-16 MU IV Q24h8-12 MU IV Q24h 8-12 MU IV Q24h 8-16 MU IV Q24h

Creatinine Clearance >50mL/min/1.73m²Creatinine Clearance 10-50mL/min/1.73m²Creatinine Clearance ≤10mL/min/1.73m²100,000-250,000 units/kg/DAY ÷ Q4H75,000-175,000 units/kg/DAY ÷ Q4H50,000-125,000 units/kg/DAY ÷ Q6H

Creatinine Clearance >50mL/min/1.73m²Creatinine Clearance 10-50mL/min/1.73m²Creatinine Clearance ≤10mL/min/1.73m²250,000-400,000 units/kg/DAY ÷ Q4H175,000-300,000 units/kg/DAY ÷ Q4H125,000-200,000 units/kg/DAY ÷ Q6H

4 million units Q4H

General Information

Adverse Effects

  • Allergy/rash (immediate or delayed)

  • Seizures

  • Cytopenias

  • Eosinophilia

  • Interstitial nephritis

  • Abnormal liver enzymes

  • Serum sickness

Drug Monitoring

Laboratory

  • CBC, CMP weekly

Additional Information

A large number of patients who are listed as penicillin-allergic will test negative for penicillin allergy on skin testing. Consult ID or Allergy/Immunology

Pharmacology

Antimicrobial class: Penicillin

Pregnancy category: B

Average serum half life: 1 hour

Biliary penetration: Therapeutic

CSF penetration: Moderate

Lung penetration: Therapeutic

Urine penetration: Therapeutic

Common Usage

Therapy of Streptococcal and other documented susceptible infections, syphilis