Benzathine benzylpenicillin

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Benzathine benzylpenicillin
Benzylpenicillin-Benzathin Structural Formula V.1.svg
Combination of
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]
AHFS/Drugs.com Professional Drug Facts
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Pregnancy
category
  • AU:A
Routes of
administration 		Intramuscular injection [3]
ATC code
Legal status
Legal status
Identifiers
CAS Number
PubChem CID
DrugBank
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UNII
KEGG
ChEBI
ChEMBL
E number E708 (antibiotics) OOjs UI icon edit-ltr-progressive.svg
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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 viscosity. [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

References

  1. ↑ Hamilton R (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 94. ISBN   9781284057560.
  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. ↑ "Product monograph brand safety updates". Health Canada . 6 June 2024. Retrieved 8 June 2024.
  5. 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.
  6. ↑ Kirkpatrick T (11 February 2020). "Why the Most Dreaded Injection is Called the 'Peanut Butter' Shot". Military.com. Retrieved 21 December 2021.
  7. ↑ 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.
  8. ↑ 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
  9. ↑ 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.
  10. ↑ 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.
  11. ↑ Gartlan WA, Rahman S, Reti K (2023). "Benzathine Penicillin". StatPearls. StatPearls Publishing. PMID   29939545.
  12. ↑ "Bicillin® L-A" (PDF). US FDA. Retrieved 31 July 2023.
  13. ↑ British Pharmacopoeia Commission Secretariat. "Index (BP 2009)" (PDF). Archived from the original (PDF) on 11 April 2009. Retrieved 26 March 2010.
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