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Penicillin G

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Usual Diluents

D5W, NS

Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate]

[0 to 4 MU] [50 ml] [30 min]*

*Sample infusion times:
-Lexi-comp (June 2013) Digital version: Intermittent I.V.: ... Infuse over 15-30 minutes.
-Micromedex (June 2013): The preferred intravenous route is by continuous infusion or intermittent piggyback injections over 30 to 60 minutes.
-AHFS DRUG INFORMATION® (2013) For intermittent IV infusion, penicillin G potassium or sodium should generally be infused over 1-2 hours..... Divided doses of the drug have also been infused intermittently IV over 15-30 minutes in neonates and children.


Stability / Miscellaneous

EXP: 1 DAY (RT) /7 DAYS (REF). Label: Refrigerate.

Stability data:

Drug Stability
Refrigerated
Stability
Room Temp.
Reconstituted
Vial/Powder
Notes
Penicillin Powder Sterile constituted solution may be kept in refrigerator 2° to 8°C (36° to 46°F) for 7 days without significant loss of potency. Store the dry powder at 20° to 25°C (68° to 77°F) Powder

STORAGE:
Admixture: All solutions should be stored in a refrigerator at 2º to 8ºC (36º to 46ºF). When refrigerated, penicillin solutions may be stored for seven days without significant loss of potency. DISCARD UNUSED SOLUTION AFTER 7 DAYS.

Reconstituted vial: Sterile constituted solution may be kept in refrigerator (2° to 8°C) for 3 days without significant loss of potency. Vial: Store dry powder at 20°-25°C (68°-77°F) (see USP Controlled Room Temperature).


Usual dose: 0.5 to 4 mu q4-6h.
Severe infection: Dosing interval q2-3h (i.e. 3mu q3h).

DOSAGE AND ADMINISTRATION
Penicillin G Potassium Injection, USP should be administered by intravenous infusion. The usual dose recommendations are as follows:

Adult patients
*Because of its short half-life, Penicillin G is administered in divided doses,usually
every 4-6 hours with the exception of meningococcal meningitis/septicemia, i.e., every 2 hours.

CLINICAL INDICATION DOSAGE
Serious infections due to susceptible strains of streptococci (including S. pneumoniae)
-septicemia, empyema, pneumonia, pericarditis, endocarditis and meningitis
12 to 24 million units/day depending on the infection and its severity administered in equally divided doses every 4-6 hours.

Serious infections due to susceptible strains of staphylococci
- septicemia, empyema, pneumonia, pericarditis, endocarditis and meningitis
5 to 24 million units/day depending on the infection and its severity administered in equally divided doses every 4-6 hours.

Anthrax Minimum of 8 million units/day in divided doses every 6 hours. Higher doses may be required depending on susceptibility of organism.
Actinomycosis
Cervicofacial disease
Thoracic and abdominal disease
1 to 6 million units/day(*)
10 to 20 million units/day(*)
Clostridial infections
Botulism (adjunctive therapy to antitoxin)
Gas gangrene (debridement and/or surgery as indicated)
Tetanus (adjunctive therapy to human tetanus immune globulin)
20 million units/day(*)
Diphtheria (adjunctive therapy to antitoxin and for the prevention of the carrier state) 2 to 3 million units/day in divided doses for 10-12 days(*)
Erysipelothrix endocarditis 12 to 20 million units/day for 4-6 weeks(*)
Fusospirochetosis (severe infections of the oropharynx [Vincent’s], lower respiratory tract and genital area) 5 to 10 million units/day(*)
Listeria infections
Meningitis
Endocarditis
15 to 20 million units/day for 2 weeks(*)
15 to 20 million units/day for 4 weeks(*)
Pasteurella infections including bacteremia and meningitis

4 to 6 million units/day for 2 weeks(*)
Haverhill fever; Rat-bite fever 12 to 20 million units/day for 3-4 weeks(*)

Disseminated gonococcal infections, such as meningitis endocarditis, arthritis, etc., caused by penicillin - susceptible organisms

10 million units/day(*); duration depends on the type of infection
Syphilis (neurosyphilis) 12 to 24 million units/day, as 2-4 MU every 4 hours for 10-14 days; many experts recommend additional therapy with Benzathine PCN G 2.4 MU IM weekly for 3 doses after completion of IV therapy

Meningococcal meningitis and/or septicemia 24 million units/day as 2 million units every 2 hours

Renal Impairment: Penicillin G is relatively nontoxic, and dosage adjustments are generally required only in cases of severe renal impairment. The recommended dosage regimens are as follows:

Creatinine clearance less than 10 mL/min/1.73m2; administer a full loading dose (see recommended dosages in the tables above) followed by one-half of the loading dose every 8-10 hours.

Uremic patients with a creatinine clearance greater than 10 mL/min/1.73m2; administer a full loading dose (see recommended dosages in the tables above) followed by one-half of the loading dose every 4-5 hours. Additional dosage modifications should be made in patients with hepatic disease and renal impairment.

Source:
PENICILLIN G POTASSIUM FOR INJECTION (penicillin g potassium) powder, for solution
[APP Pharmaceuticals, LLC] Schaumburg, IL 60173. Revised: 09/2009.

Penicillin G