Penicillin G Aqueous

DEA Class; Rx

Common Brand Names; Pfizerpen, penicillin G potassium, penicillin G sodium, Crystapen

  • Penicillins, Natural

Naturally derived antibiotic for parenteral use. Commercially available as salts of potassium or sodium; these aqueous and crystalline forms administered IV or IM. Primary agent for Streptococcus pyogenes, S. pneumoniae, and enterococcal infections. Drug of choice for the treatment of treponemal infection.

Indicated for the treatment of bacteremia or empyema.

For the treatment of clostridial diseases, including botulism, gas gangrene, and tetanus.
For the treatment of inhalation anthrax infection caused by susceptible strains of Bacillus anthracis.
For the treatment of infective endocarditis.
For the treatment of disseminated gonorrhea.
For the treatment of listeriosis.
For the adjunctive treatment of diphtheria and to prevent establishment of carrier state.
For the treatment of rat-bite fever or Haverhill fever.
For the treatment of actinomycosis.
For the treatment of fusospirochetosis or Vincent’s infection, including necrotizing ulcerative gingivitis, oropharynx infections, lower respiratory tract infections, and genital infections caused by Fusobacterium sp.
For the treatment of pericarditis.
For the treatment of peritoneal dialysis-related peritonitis.

Allergy to penicillins, cephalosporins, imipenem

Seizure

Anemia

Interstitial nephritis

Hypersensitivity

Anaphylaxis

Jarisch-Herxheimer reaction

Positive Coombs’ reaction

Serious and occasionally fatal hypersensitivity (anaphylactic) reactions reported; reactions likely to occur in individuals with a history of penicillin hypersensitivity and/or a history of sensitivity to multiple allergens; before initiating therapy, inquire about previous hypersensitivity reactions to penicillins, cephalosporins, or other allergens; discontinue and institute appropriate therapy If an allergic reaction occurs

Severe cutaneous adverse reactions (SCAR), such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP) reported when SCAR is suspected, discontinue therapy and consider an alternative treatment

The use of antibiotics may promote overgrowth of nonsusceptible organisms, including fungi; indwelling intravenous catheters encourage superinfections; should superinfection occur, appropriate measures should be taken; when indicated, incision and drainage or other surgical procedures should be performed in conjunction with antibiotic therapy

Care should be taken to avoid intravenous or accidental intraarterial administration, or injection into or near major peripheral nerves or blood vessels, since such injections may produce neurovascular damage; particular care should be taken with IV administration because of possibility of thrombophlebitis

Skipping doses or not completing the full course of therapy may decrease the effectiveness of the immediate treatment and increase the likelihood that bacteria will develop resistance and will not be treatable by Penicillin G Potassium for Injection, USP or other antibacterial drugs in the future

In renal/hepatic impairment, reduce dose based on severity of impairment

Pregnancy Category: B

Lactation: excreted in breast milk

Adults

24 million units/day IV/IM is FDA-approved maximum; up to 30 million units/day IV/IM has been used off-label.

Geriatric

24 million units/day IV/IM is FDA-approved maximum; up to 30 million units/day IV/IM has been used off-label.

Adolescents

300,000 units/kg/day IV/IM (Max: 24 million units/day) is FDA-approved maximum; up to 400,000 units/kg/day IV/IM (Max: 24 million units/day) has been used off-label.

Children

300,000 units/kg/day IV/IM (Max: 24 million units/day) is FDA-approved maximum; up to 400,000 units/kg/day IV/IM (Max: 24 million units/day) has been used off-label.

Infants

300,000 units/kg/day IV/IM is FDA-approved maximum; up to 400,000 units/kg/day IV/IM has been used off-label.

Neonates

8 days and older: 200,000 units/kg/day IV/IM.
0 to 7 days: 150,000 units/kg/day IV/IM.

Penicillin G sodium, Penicillin G potassium

premixed injectable solution

  • 1 million units/50mL
  • 2 million units/50mL
  • 3 million units/50mL

potassium, powder for injectable solution

  • 5 million units/vial
  • 20 million units/vial

sodium, powder for injectable solution

  • 5 million units/vial

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