Natural Penicillin

Aka: Natural Penicillin, Penicillin, Benzathine, Bicillin

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II. Types: Penicillin Categories

  1. Natural Penicillins (see below)
    1. Penicillin G
    2. Procaine Penicillin G
    3. Penicillin V
    4. Benzathine
  2. Aminopenicillins
    1. Ampicillin or Amoxicillin
    2. Augmentin or Unasyn
  3. Extended Spectrum Penicillin
    1. Ticarcillin
    2. Piperacillin
    3. Carbenicillin
    4. Timentin
  4. Penicillinase-Resistant Semisynthetic Penicillin
    1. Cloxacillin
    2. Dicloxacillin
    3. Methicillin
    4. Nafcillin
    5. Oxacillin

III. Mechanism: Action

  1. Inhibits cell wall synthesis

IV. Mechanism: Penicillin Resistance mechanisms

  1. Bacterial Production of Beta lactamase
    1. Staphylococcus aureus
    2. Staphylococcus epidermidis
    3. Neisseria gonorrhoeae
    4. Moraxella catarrhalis
  2. Bacterial Alteration in Penicillin-binding Proteins
    1. Streptococcus Pneumoniae (Pneumococcus)

V. Indications: Antibacterial Activity Spectrum

  1. General Spectrum
    1. Gram Positive Cocci
    2. Gram Positive bacilli
    3. Spirochetes
    4. Gram Negative Coccobacilli
    5. Anaerobic Bacteria
  2. Penicillin drug of choice in:
    1. Gram Positive Cocci
      1. Group A Streptococcus (Streptococcus Pyogenes)
      2. Group B Streptococcus (Streptococcus agalactiae)
      3. Streptococcus Pneumoniae
    2. Spirochetes
      1. Treponema pallidum (Syphilis)

VI. Dosing: Child

  1. Penicillin G
    1. Standard Dosing
      1. Penicillin G 100-150k U/Kg/day IV/IM divided q4-6h
    2. Group B Streptococcus or Meningitis
      1. Penicillin G 250k-300k U/Kg/day IV/IM divided q4h
    3. HaemophilusInfluenzae Meningitis
      1. Penicillin G 400,000 units/kg/day IV divided q4h
  2. Benzathine Penicillin (Bicillin LA)
    1. Weight <27 kg: 0.3 to 0.6 Million Units IM for 1 dose
    2. Weight >27 kg: 0.9 to 1.2 Million Units IM for 1 dose
  3. Penicillin V (Pen-Vee K)
    1. Supplied: 125 or 250 mg/5ml elixir
    2. Dosing: 25-50 mg/kg/day divided qid

VII. Adverse Effects

  1. Anaphylaxis and other Hypersensitivity Reactions
  2. Nephritis
  3. Hyperkalemia
  4. Seizures

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Related Studies

Cost: Medications

penicillin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PENICILLIN VK 125 MG/5 ML SOLN Generic $0.07 per ml
PENICILLIN VK 250 MG TABLET Generic $0.06 each
PENICILLIN VK 250 MG/5 ML SOLN Generic $0.05 per ml
PENICILLIN VK 500 MG TABLET Generic $0.10 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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