Penicillin (Includes Penicillin G and Penicillin VK)

C difficile risk
Low
Oral Bioavailability
Moderate

Dosing

Penicillin G (IV): 12 - 24 million units/day IV in 4 - 6 divided doses

Penicillin VK (PO): 300 - 600 mg PO BID - QID

Penicillin G (IV): 5 million units IV x 1 dose, THEN 2.5 million units IV q4h until delivery

Post-natal age 0 to 7 daysPost Natal age greater than 7 daysMeningitis0 - 2 kg: 0.05 million units/kg/dose IV q12h
2+ kg: 0.05 million units/kg/dose IV q8h0 - 1.2 kg: 0.05 million units/kg/dose IV q12h
1.2 - 2 kg: 0.05 million units/kg/dose IV q8h
2+ kg: 0.05 million units/kg/dose IV q6hPNA-days 0 - 7: 0.25-0.45 million units/kg/24h IV divided q8h
PNA-days 8+: 0.5 million units/kg/24h IV divided q6h

RouteFinal DilutionDilution InstructionsStabilityIV50,000 Units/mLSupplied by Pharmacy24 hours

0 - 10 eGFR10 - 50 eGFR50+ eGFRAdminister 25 - 50% of normal dose.Administer 75% of normal dose.No dosage adjustment required.

General Information

Pencillin G (IV): Therapy of Streptococcal and other documented susceptible infections (including invasive Group A Streptoccus infections), neurosyphilis, intrapartum Group B Streptococcus prophylaxis.

Penicillin VK: Streptococcal infections and therapy of documented susceptible infection not requiring parenteral therapy (i.e. upper respiratory tract, urinary tract infections), prophylaxis after rheumatic fever

Pregnancy: Compatible.

Breastfeeding: Compatible.

  • Monitor for allergic reaction

  • Periodic CBC, SCr

  • Allergy/rash (immediate or delayed)

  • Seizures (IV therapy, high doses)

  • Cytopenias

  • Eosinophilia

  • Interstitial nephritis

  • Abnormal liver enzymes

  • Serum sickness

  • Positive Coombs

No significant drug interactions.

For patients reporting allergies to penicillins: take an allergy history, refer to the allergy management section on this site including the penicillin and beta lactam allergy management tool and cross reactivity table. Call Antimicrobial Stewardship for assistance.

Antimicrobial class: Penicillin