Penicillin

:For the Japanese rock band, see Penicillin (band).

Variants

Benzathine penicillin

Benzathine penicillin is slowly absorbed into the circulation, after intramuscular injection, and hydrolysed to benzylpenicillin in vivo. It is the drug-of-choice when prolonged low concentrations of benzylpenicillin are required and appropriate, allowing prolonged antibiotic action over 2–4 weeks after a single IM dose. It is marketed by Wyeth under the trade name Bicillin®.

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Specific indications for benzathine pencillin include: (Rossi, 2004)

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• prophylaxis of rheumatic fever
• early or latent syphilis

Benzylpenicillin (penicillin G)

Benzylpenicillin, commonly known as penicillin G, is the gold standard penicillin. Penicillin G is typically given by a parenteral route of administration because it is unstable to the hydrochloric acid of the stomach. Because the drug is given parenterally, higher tissue concentrations of penicillin G can be achieved than is possible with phenoxymethylpenicillin. These higher concentrations translate to increased antibacterial activity.

Related Topics:
Gold standard - Route of administration - Hydrochloric acid

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Specific indications for benzylpenicillin include: (Rossi, 2004)

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• bacterial endocarditis
• meningitis
• aspiration pneumonia, lung abscess
• community-acquired pneumonia
• syphilis
• septicaemia in children

Phenoxymethylpenicillin (penicillin V)

Phenoxymethylpenicillin, commonly known as penicillin V, is the orally-active form of penicillin. It is less active than benzylpenicillin, however, and is only appropriate in conditions where high tissue concentrations are not required.

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Specific indications for phenoxymethylpenicillin include: (Rossi, 2004)

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• infections caused by Streptococcus pyogenes
• tonsilitis
• pharyngitis
• skin infections
• prophylaxis of rheumatic fever
• moderate-to-severe gingivitis (with metronidazole)

Procaine penicillin

Procaine penicillin (Bicillin®) is a combination of benzylpenicillin with the local anaesthetic agent procaine. This combination is aimed at reducing the pain and discomfort associated with a large intramuscular injection of penicillin.

Related Topics:
Local anaesthetic - Procaine - Intramuscular

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Specific indications for procaine penicillin include: (Rossi, 2004)

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• respiratory tract infections where compliance with oral treatment is unlikely
• syphilis
• cellulitis