Benzathine benzylpenicillin

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Benzathine benzylpenicillin
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Benzylpenicillin antibiotic
Benzathine stabilizer
Clinical data
Trade names Bicillin L-A, [1] Permapen, others
Other namespenicillin benzathine benzyl, benzathine penicillin, penicillin G benzathine, benzylpenicillin benzathine [2]
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Intramuscular injection [3]
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Benzathine benzylpenicillin, also known as benzathine penicillin G (BPG), is an antibiotic medication useful for the treatment of a number of bacterial infections. [3] Specifically it is used to treat strep throat, diphtheria, syphilis, and yaws. [3] [4] It is also used to prevent rheumatic fever. [4] It is given by injection into a muscle. [3] [4] It is known as "Peanut Butter Shot" in US military slang due to its appearance. [5]

Contents

Side effects include allergic reactions including anaphylaxis, and pain at the site of injection. [4] When used to treat syphilis a reaction known as Jarisch-Herxheimer may occur. [4] It is not recommended in those with a history of penicillin allergy or those with syphilis involving the nervous system. [4] [3] Use during pregnancy is generally safe. [3] It is in the penicillin and beta lactam class of medications and works via benzylpenicillin. [3] [4] The benzathine component slowly releases the penicillin making the combination long acting. [6]

Benzathine benzylpenicillin was patented in 1950. [2] [7] It is on the World Health Organization's List of Essential Medicines. [8]

Medical uses

It is used to treat strep throat, diphtheria, syphilis, and yaws. [3] [4]

Chemopreventive

A single large 1.2-million-unit dose of intramuscular BPG is given to US military recruits. The Army in particular has a policy to inject all recruits if not allergic, though supply issues and individual base choices have reduced the coverage. A retrospective analysis shows that it reduces the rate of all-cause acute respiratory disease by 32% among Army recruits. [9]

Adverse effects

2,400,000 units of Bicillin L-A brand of benzylpenicillin, for deep intramuscular injection Bicillin L-A (Benzylpenicillin).jpg
2,400,000 units of Bicillin L-A brand of benzylpenicillin, for deep intramuscular injection

The possible adverse effects are generally similar to other forms of penicillin. BPG is overall well-tolerated, but pain from the injection site is a common concern. [10]

Mechanism of action

It is in the penicillin class of medications. It 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.[ citation needed ]

Society and culture

It is marketed by Pfizer (formerly by Wyeth) under the trade name Bicillin L-A. [11]

Compendial status

Related Research Articles

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<span class="mw-page-title-main">Yaws</span> Medical condition

Yaws is a tropical infection of the skin, bones, and joints caused by the spirochete bacterium Treponema pallidum pertenue. The disease begins with a round, hard swelling of the skin, 2 to 5 cm in diameter. The center may break open and form an ulcer. This initial skin lesion typically heals after 3–6 months. After weeks to years, joints and bones may become painful, fatigue may develop, and new skin lesions may appear. The skin of the palms of the hands and the soles of the feet may become thick and break open. The bones may become misshapen. After 5 years or more, large areas of skin may die, leaving scars.

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<span class="mw-page-title-main">Cefixime</span> A third generation cephalosporin antibiotic

Cefixime, sold under the brand name Suprax among others, is an antibiotic medication used to treat a number of bacterial infections. These infections include otitis media, strep throat, pneumonia, urinary tract infections, gonorrhea, and Lyme disease. For gonorrhea typically only one dose is required. In the United States it is a second-line treatment to ceftriaxone for gonorrhea. It is taken by mouth.

<span class="mw-page-title-main">Piperacillin/tazobactam</span> Combination antibiotic medication

Piperacillin/tazobactam, sold under the brand name Tazocin among others, is a combination medication containing the antibiotic piperacillin and the β-lactamase inhibitor tazobactam. The combination has activity against many Gram-positive and Gram-negative bacteria including Pseudomonas aeruginosa. It is used to treat pelvic inflammatory disease, intra-abdominal infection, pneumonia, cellulitis, and sepsis. It is given by injection into a vein.

<span class="mw-page-title-main">Imipenem/cilastatin</span> Combination antibiotic medication

Imipenem/cilastatin, sold under the brand name Primaxin among others, is an antibiotic useful for the treatment of a number of bacterial infections. It is made from a combination of imipenem and cilastatin. Specifically it is used for pneumonia, sepsis, endocarditis, joint infections, intra-abdominal infections, and urinary tract infections. It is given by injection into a vein or muscle.

<span class="mw-page-title-main">Cefotaxime</span> Chemical compound

Cefotaxime is an antibiotic used to treat a number of bacterial infections in human, other animals and plant tissue culture. Specifically in humans it is used to treat joint infections, pelvic inflammatory disease, meningitis, pneumonia, urinary tract infections, sepsis, gonorrhea, and cellulitis. It is given either by injection into a vein or muscle.

<span class="mw-page-title-main">Spectinomycin</span> Antibiotic

Spectinomycin, sold under the tradename Trobicin among others, is an antibiotic useful for the treatment of gonorrhea infections. It is given by injection into a muscle.

<span class="mw-page-title-main">Phenoxymethylpenicillin</span> Antibiotic medication

Phenoxymethylpenicillin, also known as penicillin V (PcV) and penicillin VK, is an antibiotic useful for the treatment of a number of bacterial infections. Specifically it is used for the treatment of strep throat, otitis media, and cellulitis. It is also used to prevent rheumatic fever and to prevent infections following removal of the spleen. It is given by mouth.

<span class="mw-page-title-main">Benzylpenicillin</span> Antibiotic medication

Benzylpenicillin, also known as penicillin G (PenG) or BENPEN, is an antibiotic used to treat a number of bacterial infections. This includes pneumonia, strep throat, syphilis, necrotizing enterocolitis, diphtheria, gas gangrene, leptospirosis, cellulitis, and tetanus. It is not a first-line agent for pneumococcal meningitis. Due to benzylpenicillin's limited bioavailability for oral medications, it is generally taken as an injection in the form of a sodium, potassium, benzathine, or procaine salt. Benzylpenicillin is given by injection into a vein or muscle. Two long-acting forms benzathine benzylpenicillin and procaine benzylpenicillin are available for use by injection into a muscle only.

Procaine benzylpenicillin also known as penicillin G procaine, is an antibiotic useful for the treatment of a number of bacterial infections. Specifically it is used for syphilis, anthrax, mouth infections, pneumonia, diphtheria, cellulitis, and animal bites. It is given by injection into a muscle.

The side effects of penicillin are bodily responses to penicillin and closely related antibiotics that do not relate directly to its effect on bacteria. A side effect is an effect that is not intended with normal dosing. Some of these reactions are visible and some occur in the body's organs or blood. Penicillins are a widely used group of medications that are effective for the treatment of a wide variety of bacterial infections in human adults and children as well as other species. Some side effects are predictable, of which some are common but not serious, some are uncommon and serious and others are rare. The route of administration of penicillin can have an effect on the development of side effects. An example of this is irritation and inflammation that develops at a peripheral infusion site when penicillin is administered intravenously. In addition, penicillin is available in different forms. There are different penicillin medications as well as a number of β-lactam antibiotics derived from penicillin.

Benzathine benzylpenicillin/procaine benzylpenicillin, sold under the brand name Bicillin C-R, is an antibiotic medication. It contains the antibiotics benzathine benzylpenicillin and procaine benzylpenicillin.

References

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  2. 1 2 Engel J, Kleemann A, Kutscher B, Reichert D, eds. (2009). Pharmaceutical Substances: Syntheses, Patents and Applications of the most relevant APIs (5th ed.). Georg Thieme Verlag. p. 134. ISBN   9783131792754. Archived from the original on 20 December 2016.
  3. 1 2 3 4 5 6 7 8 "Penicillin G Benzathine (Professional Patient Advice) - Drugs.com". www.drugs.com. Archived from the original on 20 December 2016. Retrieved 10 December 2016.
  4. 1 2 3 4 5 6 7 8 World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. pp. 98, 104. hdl: 10665/44053 . ISBN   9789241547659.
  5. Kirkpatrick T (11 February 2020). "Why the Most Dreaded Injection is Called the 'Peanut Butter' Shot". Military.com. Retrieved 21 December 2021.
  6. Ebadi M (2007). "Penicillin G". Desk Reference of Clinical Pharmacology (2nd ed.). CRC Press. p. 555. ISBN   9781420047448. Archived from the original on 20 December 2016.
  7. USpatent 2627491,Szabo JL, Bruce WF,"Penicillin salts of substituted alkylene diamines",published 1953-02-03,issued 1953-02-03, assigned to Wyeth LLCand Wyeth Inc
  8. World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl: 10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  9. Ball JD, Prosperi MA, Brown A, Chen X, Kenah E, Yang Y, et al. (October 2018). "The role of benzathine penicillin G in predicting and preventing all-cause acute respiratory disease in military recruits: 1991-2017". Epidemiology and Infection. 146 (14): 1854–1860. doi: 10.1017/S0950268818001838 . PMC   9506690 . PMID   29974837.
  10. Gartlan WA, Rahman S, Reti K (2023). "Benzathine Penicillin". StatPearls. StatPearls Publishing. PMID   29939545.
  11. "Bicillin® L-A" (PDF). US FDA. Retrieved 31 July 2023.
  12. British Pharmacopoeia Commission Secretariat. "Index (BP 2009)" (PDF). Archived from the original (PDF) on 11 April 2009. Retrieved 26 March 2010.