Benzylpenicillin

Benzylpenicillin – antibacterial drug of penicillinic group.

Form of release and structure

Benzylpenicillin is produced in the form of powder for preparation of solution for injections (in bottles on 10 ml).

1 bottle contains benzylpenicillin sodium salt on 500 thousand ME and 1 million ME.

Indications to use

• Heavy generalized infections (meningitis, septicaemia, the disseminated gonococcal infection);
• Respiratory infections (pneumonia) and skin (erysipelatous inflammation);
• Inborn syphilis;
• Streptococcal endocarditis;
• Tetanus;
• Abscesses;
• Lymphadenitis and lymphangitis;
• Malignant anthrax;
• Osteomyelitis;
• Gas gangrene.

Contraindications

Benzilpenitsillin's use is contraindicated at hypersensitivity to penicillin.

With care drug is appointed to the feeding and pregnant women.

Route of administration and dosage

Benzilpenitsillin's dosage is defined by type and weight of an infection.

The approximate recommended doses:

• Adults: 1800-3600 mg (3-6 million ME) a day divided into 4-6 receptions. At heavy infections (a septicaemia, meningitis) the dosage is calculated proceeding from weight – to 200-300 mg/kg (330-500 thousand ME/kg) a day. In this case therapy should be begun with a slow intravenous injection or with bystry infusion, using as a thinner 5% glucose;
• Children: at the rate of 30-90 mg/kg (50-150 thousand ME/kg) a day in 4-6 receptions. At heavy infections the dosage can be increased to 300 mg/kg (500 thousand ME/kg).

Benzylpenicillin can be applied also intramusculary, diluting drug just before use as its activity in infusion solutions quickly decreases. Duration of therapy is defined by indications and a clinical picture.

The recommended dosages at individual diseases make:

• The septicaemia and meningitis caused by meningokokka: within at least 5 days in the form of a slow intravenous injection or infusion on 180-240 mg/kg (300-400 thousand ME/kg) a day in 4-6 receptions;
• The septicaemia and meningitis caused by pneumococci: within at least 10 days in the form of a slow intravenous injection or infusion on 240-300 mg/kg (400-500 thousand ME/kg) a day in 4-6 receptions;
• The infections caused by clostridiums: within 7 days as addition to therapy with antitoxin for 9 000-12 000 mg (15-20 million ME) in day the adult and 180 mg/kg (300 thousand ME/kg) to children;
• Streptococcal endocarditis: within 14-28 days on 6 000-12 000 mg (10-20 million ME) a day the adult and 180 mg/kg (300 thousand ME/kg) to children;
• Inborn syphilis: in 2 receptions within 14 days intramusculary or intravenously on 30 mg/kg (50 thousand ME/kg) a day.

Side effects

At Benzilpenitsillin's use there can be allergic reactions which are shown as:

• Intersticial nephrite, rash on mucous membranes, a Quincke's disease, a small tortoiseshell, a hyperthermia, skin rash, an arthralgia, an eosinophilia, a bronchospasm (often);
• Acute anaphylaxis (seldom).

At the beginning of a therapy course (especially inborn syphilis) Benzilpenitsillin can cause fever, a fever, an exacerbation of a disease, the increased sweating, Yarisha-Gerksgeymer's reactions.

From local reactions development of morbidity and consolidation in the place of intramuscular introduction is the most probable.

At prolonged use of Benzilpenitsillin there can be dysbacteriosis and development of superinfection.

Special instructions

In cases if in 2-3 days (as much as possible – 5 days) after the beginning of use of Benzilpenitsillin the effect is not observed, it is necessary to pass to use of other antibiotic means or to a combination therapy.

Because of the existing risk of development of fungal infections at therapy by drug, if necessary, the doctor appoints antifungal medicines.

To avoid emergence of resistant strains of activators, it is necessary to avoid use of insufficient doses of drug or too early termination of treatment.

Analogs

On the action mechanism Benzilpenitsillin's analogs are: Benzatinbenzilpenitsillin, Benzitsillin-1 (-3,-5), Bicillinum-1 (-3,-5), Moldamin, Ospenum 750, Retarpen, Is old - Pen, Fenoksimetilpenitsillin.

Terms and storage conditions

Drug is released according to the recipe of the doctor. A period of validity – 4 years at a temperature up to 30 °C. A period of storage of the solution prepared from powder for injections – 24 hours (in the refrigerator – 72 hours), solution for infusions – 12 hours (in the refrigerator – 24 hours).