Penicillin G

Usual Dosing (Adults)

Penicillin G:
1 – 4 mu q4-6h.
(Susceptible infections: I.M., I.V.: 2-24 million units/day in divided doses every 4 hours depending on sensitivity of the organism and severity of the infection.)
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Penicillin VK:
250-500mg orally q6h.

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 Dosing

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.

Hemodialysis

Dose as for CrCl<10.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
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