Benzathine benzylpenicillin

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Benzathine benzylpenicillin
Benzylpenicillin-Benzathin Structural Formula V.1.svg
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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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  • AU:A
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Intramuscular injection [3]
ATC code
Legal status
Legal status
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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] [5] It is also used to prevent rheumatic fever. [5] It is given by injection into a muscle. [3] [5] It is known as "Peanut Butter Shot" in US military slang due to its appearance. [6]

Contents

Side effects include allergic reactions including anaphylaxis, and pain at the site of injection. [5] When used to treat syphilis a reaction known as Jarisch-Herxheimer may occur. [5] It is not recommended in those with a history of penicillin allergy or those with syphilis involving the nervous system. [5] [3] Use during pregnancy is generally safe. [3] It is in the penicillin and beta lactam class of medications and works via benzylpenicillin. [3] [5] The benzathine component slowly releases the penicillin making the combination long acting. [7]

Benzathine benzylpenicillin was patented in 1950. [2] [8] It is on the World Health Organization's List of Essential Medicines. [9]

Medical uses

It is used to treat strep throat, diphtheria, syphilis, and yaws. [3] [5]

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. [10]

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. [11]

Society and culture

It is marketed by Pfizer (formerly by Wyeth) under the trade name Bicillin L-A. [12]

Compendial status

Related Research Articles

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Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The signs and symptoms depend on the stage it presents: primary, secondary, latent or tertiary. The primary stage classically presents with a single chancre, though there may be multiple sores. In secondary syphilis, a diffuse rash occurs, which frequently involves the palms of the hands and soles of the feet. There may also be sores in the mouth or vagina. Latent syphilis has no symptoms and can last years. In tertiary syphilis, there are gummas, neurological problems, or heart symptoms. Syphilis has been known as "the great imitator", because it may cause symptoms similar to many other diseases.

<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">Congenital syphilis</span> Presence of syphilis in a baby due to its mother being infected

Congenital syphilis is syphilis that occurs when a mother with untreated syphilis passes the infection to her baby during pregnancy or at birth. It may present in the fetus, infant, or later. Clinical features vary and differ between early onset, that is presentation before 2-years of age, and late onset, presentation after age 2-years. Infection in the unborn baby may present as poor growth, non-immune hydrops leading to premature birth or loss of the baby, or no signs. Affected newborns mostly initially have no clinical signs. They may be small and irritable. Characteristic features include a rash, fever, large liver and spleen, a runny and congested nose, and inflammation around bone or cartilage. There may be jaundice, large glands, pneumonia, meningitis, warty bumps on genitals, deafness or blindness. Untreated babies that survive the early phase may develop skeletal deformities including deformity of the nose, lower legs, forehead, collar bone, jaw, and cheek bone. There may be a perforated or high arched palate, and recurrent joint disease. Other late signs include linear perioral tears, intellectual disability, hydrocephalus, and juvenile general paresis. Seizures and cranial nerve palsies may first occur in both early and late phases. Eighth nerve palsy, interstitial keratitis and small notched teeth may appear individually or together; known as Hutchinson's triad.

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

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Pinta is a human skin disease caused by infection with the spirochete Treponema carateum, which is morphologically and serologically indistinguishable from the bacterium that causes syphilis and bejel. The disease was previously known to be endemic to Mexico, Central America, and South America; it may have been eradicated since, with the latest case occurring in Brazil in 2020.

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

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

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<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.

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<span class="mw-page-title-main">Oriol Mitjà</span> Catalan researcher

Oriol Mitjà i Villar is a Catalan-born Spanish researcher and consultant physician in internal medicine and infectious diseases with expertise in poverty-related tropical diseases. He has conducted research at the Lihir Medical Centre in Papua New Guinea since 2010 on new diagnostic and therapeutic tools to eradicate yaws. He was awarded the Princess of Girona Award in the scientific research category. Currently at the Germans Trias i Pujol Research Institute, Mitjà is conducting research on SARS-CoV-2 coronavirus disease (COVID-19) and strategies to control the infection at a community level.

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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  6. Kirkpatrick T (11 February 2020). "Why the Most Dreaded Injection is Called the 'Peanut Butter' Shot". Military.com. Retrieved 21 December 2021.
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