GENERIC NAME: penicillin G benzathine injectable suspension
BRAND NAME: Bicillin L-A
DRUG CLASS AND MECHANISM: Penicillin G benzathine (Bicillin L-A) is a penicillin antibiotic that is given by deep intramuscular injection. Penicillin G benzathine kills susceptible bacteria by inhibiting the synthesis or formation of bacterial cell wall. It is thought to preferentially bind to specific penicillin-binding proteins (PBPs) found inside the bacterial cell wall. The end result of the inhibition of bacterial cell synthesis is cell lysis and the death of the susceptible bacteria.
Penicillin G benzathine has poor solubility and is therefore very slowly released from the site of injection. In the blood, penicillin G benzathine is broken down to penicillin G. Penicillin G benzathine formulation is released and absorbed slowly to allow for a more prolonged duration of action (drug works slowly over an longer period of time).
GENERIC AVAILABLE: Not available in the US
PREPARATIONS: Penicillin G benzathine injectable suspension: 1 ml (600,000 units per syringe), 2 ml (1,200,000 units per syringe), and 4 ml (2,400,000 units per syringe).
STORAGE: Suspension should be stored in a refrigerator, between 2 C and 8 C (36 F and 86 F).
Intramuscular penicillin G benzathine is used to treat the following conditions:
- Mild to moderate upper respiratory tract infections caused by susceptible species of the streptococci bacteria
- Sexually transmitted diseases (STDs) syphilis, yaws, bejel, and pinta.
- Streptococcal (Group A) upper respiratory infections: Adult patients are administered a single injection of 1,200,000 units; older pediatric patients are administered a single injection of 900,000 units; infants and pediatric patients < 60 Ibs are administered 300,000 to 600,00 units.
- Syphilis: For the treatment of primary, secondary, and latent syphilis the recommended dose is 2,400,000 units as a one-time dose. For the treatment of tertiary and neurosyphilis the recommended dose is 2,400,000 every 7 days for a total of three doses. For the treatment of congenital syphilis in patients under the age of 2, the recommended dose is 50,000 units/kg.
- Yaws, Bejel, and Pinta: The recommended dose is 1,200,000 units administered as a single injection.
- Prevention of rheumatic fever and glomerulonephritis: After an acute attack, penicillin G benzathine may be given in doses of 1,200,000 units once a month or 600,000 units every 2 weeks.
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