Benzylpenicillin (Benzylpenicillin sodium salt): instructions for use
Before buying the drug Benzylpenicillin, you should carefully read the instructions for use, methods of administration and dosage, as well as other useful information on the preparation Benzylpenicillin. On the site "Encyclopaedia of Diseases" you will find all the necessary information: instructions for proper use, recommended dosage, contraindications, as well as reviews of patients who have already used this medication.
Benzylpenicillin sodium salt is an antimicrobial agent, an antibiotic of the penicillin group, a sodium salt of benzylpenicillic acid, produced by various kinds of mold fungi.
Benzylpenicillin - Composition and form of release
A powder is prepared for the preparation of a solution for injection in hermetically sealed bottles containing 100,000 units, 125,000 units, 250,000 units, 300,000, 400,000 units, 500,000 units and 1,000,000 units.
The unit of action (ED) of penicillin is the activity of 0.6 μg of the sodium salt of benzylpenicillin.
Benzylpenicillin sodium salt (Benzylpenicillinum-natrium, Benzylpenicillinum natricum) is a white, fine-grained powder of bitter taste, readily soluble in water.
The sodium salt of benzylpenicillin is easily destroyed by the action of alkalis, acids, oxidants, with heating and under the influence of the enzyme penicillinase.
Benzylpenicillin - Therapeutic properties
Benzylpenicillin has a bactericidal effect against microorganisms sensitive to penicillin; is active against gram-positive microorganisms (staphylococci, streptococci, pneumococci, corynebacteria diphtheria, anaerobic spore-forming rods, anthrax rods), gram-negative cocci (gonococci, meningococci), spirochetes and actinomycetes. It acts on microorganisms located intracellularly.
Preparations of benzylpenicillin are used for general effects (mainly intramuscular), effects on organs and tissues in which a small amount of penicillin penetrates the blood (subarachnoidal injection for action on the spinal cord and brain, the meninges in inflammatory processes in them) and for local action on various organs and tissues.
The maximum concentration of benzylpenicillin in the blood after intramuscular injection is observed after 30-60 minutes, with subcutaneous injection - after 60 minutes; the drug is quickly excreted by the kidneys and after 4-6 hours only subtherapeutic concentration of antibiotic is detected in the blood, therefore it is necessary to inject it every 3-4 hours.
The use of benzylpenicillin can be combined in the administration of sulfonamide drugs and other antibiotics - while the therapeutic effect of the drugs used increases.
Benzylpenicillin - Indications for use
Diseases caused by susceptible to benzylpenicillin by microorganisms: diseases of the respiratory tract and lungs (pneumonia, etc.), severe septic diseases, septic endocarditis , sepsis , infections and infected wounds of the skin, soft tissues and mucous membranes, burns, inflammatory diseases of the brain and spinal cord, cerebral membranes, purulent pleurisy, peritonitis, cystitis , septicemia and pyemia, osteomyelitis , diphtheria , scarlet fever , gonorrhea , erysipelas, neonatal blenorrhea, syphilis , anthrax , actinomia goats , obstetric-gynecological practice, inflammatory diseases of the ear, throat and nose, and other diseases.
Benzylpenicillin - Application rules
The course of treatment with the drug, depending on the nature and course of the disease, can last from several days (4-8 days with scarlet fever, pneumonia, erysipelas) to 1-2 months or more (with septic endocarditis). With uncomplicated gonorrhea treatment is carried out for one day.
Intramuscular injection of the sodium salt of benzylpenicillin is performed in the outer upper quadrant of the gluteal region. The ratio of benzylpenicillin salt to the solvent (distilled water, isotonic sodium chloride solution or 0.25-0.5% novocaine solution) is 100,000 units / 1 ml. The solutions are prepared ex tempore without heating.
The average therapeutic dose of the sodium salt of benzylpenicillin is: one-time - 50 000-300 000 units, daily - 200 000-1 000 000-2 000 000 units when administered 3-6 times a day at regular intervals.
With an average infection of benzylpenicillin, the sodium salt is administered intramuscularly and subcutaneously at 250,000-500,000 units; The daily doses are 10,000,000-20,000,000 units.
Intravenous administration of benzylpenicillins (only for severe diseases - sepsis, septic endocarditis, meningitis , etc.) is repeated (every 3-4 hours) or continuously by drop method: 30-40 drops of the drug solution in 1 minute for 6-12 hours.
In severe infections, up to 10 000 000-20 000 000 units per day is administered; with gas gangrene - 40 000 000-60 000 000 units.
Endolumbalnoe introduction is used for inflammatory diseases of the brain, spinal cord and meninges. The solution is prepared at the rate of 1000-10 000 units per 1 ml of sterile isotonic sodium chloride solution. Benzylpenicillin is administered slowly (within 1-2 minutes) at a dose, depending on the nature of the disease, from 5000 to 30 000 units (adults) or from 2000 to 5000 units (children) after preliminary release of 5-10 ml of cerebrospinal fluid. The daily intake for adults is 25 000-100 000 units.
Sometimes a solution of the sodium salt of benzylpenicillin is used to cut foci of actinomycosis, leishmaniasis of the skin of urban type, chronic pyoderma and other infectious skin diseases in the absence of acute inflammation.
For inhalations for the prevention and treatment of respiratory and lung diseases, benzylpenicillins are used in the form of aerosols. One inhalation consumes 100 000-300 000 units of ED dissolved in 3-5 ml of distilled water or isotonic sodium chloride solution. According to the indications, add 1 ml of a 1% solution of ephedrine or 1 ml of a 1% solution of dimedrol. Inhalations are performed 1-2 times a day, the duration of inhalation is 10-30 minutes.
Enter into the abdominal or pleural cavity for peritonitis and purulent pleurisy 10 000-50 000 units per 100 ml of sterile isotonic sodium chloride solution.
For topical application in cases of infected wounds of soft tissues, burns, osteomyelitis, etc., solutions of benzylpenicillins in the form of washes, lotions, moist dressings, powders (often mixed with sulfonamides), ointments on a lanolin-vaseline basis (5000-10 000 ED for 1 g of ointment base), at least 2 times a day.
For the treatment of eye, nose, ear, mouth and throat diseases solutions of benzylpenicillin (1000-50 000 units / ml) are used on isotonic sodium chloride solution in the form of drops, lotions, moist bandages, compresses.
In ophthalmology appoint solutions of benzylpenicillins - 10 000-20 000 units in 1 ml of isotonic sodium chloride solution 1-2 drops 6-8 times a day. Ointments - 1000-10 000 units per 1 g of ointment base.
Solutions of 25,000 U / ml are used to prevent neonatal blenorrhea.
Benzylpenicillin - Side Effects
The most common side effect of the drug is observed with intravenous benzylpenicillin.
Benzylpenicillin sodium salt and other penicillin preparations can cause various side effects. In some patients, especially with increased sensitivity, headache , fever, urticaria , rash on the skin and mucous membranes, joint pain, eosinophilia (an increase in the number of eosinophils in the blood), angioedema (allergic) edema and other allergic reactions; cases of anaphylactic shock (an allergic reaction of an immediate type) with a fatal outcome are described.
In case of severe allergic reactions, adrenaline, glucocorticoids, antihistamines (dimedrol and others), calcium chloride are prescribed. Enzyme preparation is also used singillinase. In severe allergic reactions, prednisolone or other glucocorticosteroids are prescribed.
At the first signs of anaphylactic shock, measures should be taken to remove the patient from this condition (adrenaline, dimedrol, calcium chloride, the use of cardiac agents, oxygen inhalation, warming, etc., immediately after removal of the patient from asphyxia / lack of breathing / and shock 1 000 000 penicillinases).
The use of very large doses of penicillin and especially with endolumbal administration can cause neurotoxic effects (nausea, vomiting, increased reflex excitability, symptoms of meningitis, the appearance of meningitis in the patient without the presence of an infectious agent in the cerebrospinal fluid, convulsions, coma, unconsciousness). Endolumbial injections should be carried out with great care.
When prescribing benzylpenicillin and drugs containing penicillin, it is necessary to find out whether the patient has had any complications (toxic-allergic reactions) with the previous use of penicillin.
In connection with the possibility of fungal lesions of the mucous membranes and skin, especially in newborns, elderly people and weakened patients, it is advisable in the treatment of penicillin to prescribe vitamins of group B and vitamin C, and if necessary Nystatin or Levorin.
The most common allergic reactions that can occur with this drug are urticaria, fever, chills, headache, joint pain, eosinophilia, Quincke edema , dermatitis, serum-like reactions (fever, arthralgia, lymphadenopathy ), in rare cases - anaphylactic shock .
Benzylpenicillin - Contraindications
Allergy to penicillin preparations.
The endolumbral administration of benzylpenicillin is contraindicated in epilepsy.
For endolumbic and intravenous (very rare) administration, only the sodium salt of benzylpenicillin is used.
For ingestion, benzylpenicillin proved to be of little use, since it is destroyed by gastric juice and enzyme penicillinase, formed by the microbial flora of the intestine.
Benzylpenicillin sodium salt is incompatible in liquid dosage forms and ointments with acids and substances having an alkaline reaction; alkalis and many substances with an alkaline reaction; oxidizers (decomposition and inactivation of the drug), alcohol and heavy metal salts - zinc sulfate, etc. (due to inactivation of benzylpenicillin).
In the development of allergic reactions should immediately stop treatment with benzylpenicillin, and, if necessary, prescribe symptomatic treatment.
If it is known that there is an allergy to procaine (novocaine), as a separate component of the drug, treatment can be continued with another, not procaine salt of benzylpenicillin.
Precautions should be observed in the treatment of patients with cardiopathy, hypovolemia (with inflammation of the circulating blood volume), epilepsy, nephropathy and liver pathology.
When administered in high doses for more than five days, electrolyte balance, kidney, liver and hematological tests are recommended.
In accordance with the WHO recommendations, treatment with streptococcal infections should last at least 10 days.
Patients receiving benzylpenicillin may have a false positive urine reaction to sugar.
In patients with diabetes, there may be a delay in the absorption of benzylpenicillin from the intramuscular depot.
It is possible to use benzylpenicillin during pregnancy and lactation as directed by a doctor.
With prolonged treatment with antibiotics, the possibility of the emergence of resistant strains of microorganisms and fungi should be taken into account.
In the case of sexually transmitted diseases, if there is a suspicion of syphilis, before the start of treatment and subsequently for at least four months, studies in the dark field and serological tests should be conducted.
Analogues of Benzylpenicillin
Benzathine benzylpenicillin (Substance-Powder)
Bicillin-1 (powder for suspension for intramuscular injection 1.2 million E)
Retarpen 1,2 (Powder for suspension for intramuscular injection)
Retarpen 2.4 (Powder for suspension for intramuscular administration)
Phenoxymethylpenicillin (Granules for the preparation of a suspension for oral administration)
Phenoxymethylpenicillin (Powder for the preparation of a suspension for oral administration)
Storage conditions and shelf life
Store in a dry place at room temperature (list B).
Shelf life of benzylpenicillin sodium salt is 3 years.
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