WHO Model Prescribing Information: Drugs Used in Skin Diseases
(1997; 132 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentPreface
View the documentIntroduction
Open this folder and view contentsParasitic infections
Open this folder and view contentsInsect and arachnid bites and stings
Open this folder and view contentsSuperficial fungal infections
Open this folder and view contentsSubcutaneous fungal infections
Open this folder and view contentsBacterial infections
Open this folder and view contentsViral infections
Open this folder and view contentsEczematous diseases
Open this folder and view contentsScaling diseases
Open this folder and view contentsPapulosquamous diseases
View the documentCutaneous reactions to drugs
Open this folder and view contentsPigmentary disorders
Open this folder and view contentsPremalignant lesions and malignant tumours
Open this folder and view contentsPhotodermatoses
Open this folder and view contentsBullous dermatoses
View the documentAlopecia areata
View the documentUrticaria
Open this folder and view contentsConditions common in children
View the documentAcne vulgaris
View the documentPruritus
View the documentTropical ulcers
Close this folderAntimicrobial drugs
View the documentAciclovir
View the documentBenzylpenicillin
View the documentClioquinol
View the documentErythromycin
View the documentMethylrosanilinium chloride (gentian violet)
View the documentNeomycin + bacitracin
View the documentTetracycline
View the documentTiabendazole
Open this folder and view contentsAntifugal drugs
Open this folder and view contentsAntiseptic agents
Open this folder and view contentsKeratoplastic and keratolytic agents
Open this folder and view contentsScabicides and pediculicides
Open this folder and view contentsAnti-inflammatory and antipruritic drugs1
Open this folder and view contentsAntiallergics and drugs used in anaphylaxis
Open this folder and view contentsUltraviolet radiation-blocking agents (sunscreens)
Open this folder and view contentsMiscellaneous drugs
Open this folder and view contentsAnnex
View the documentSelected WHO Publications of Related Interest
View the documentBack cover
 

Benzylpenicillin

Benzylpenicillin: powder for injection, 600 mg (=1 million IU), 3g (=5 million IU) (as sodium or potassium salt) in 5-ml vial
Benzathine benzylpenicillin: powder for injection, 1.44 g of benzylpenicillin (=2,4 million IU) in 5-ml vial
Procaine benzylpenicillin: powder for injection, 1 g (=1 million IU), 3g (=3 million IU) in vial

General information

Benzylpenicillin is a β-lactam antibiotic produced by Penicillin spp. It is bactericidal against streptococci, neisseriae, many anaerobes and spirochaetes.

After intramuscular injection, peak plasma concentrations are reached within 15-30 minutes. It is widely distributed throughout the body, has a plasma half-life of 30 minutes and is excreted mainly in the urine.

Repository formulations of benzyl-penicillin are available for parenteral use. They are designed to provide a tissue depot from which the drug is slowly absorbed over a period of 12 hours to several days. Procaine benzylpenicillin produces a peak plasma concentration within 1-3 hours and is excreted over a period of several days, while benzathine benzylpenicillin takes 13-24 hours to reach its peak plasma concentration and is detectable in the urine for 3-4 weeks.

Clinical information

Uses

Treatment of:

• severe pyodermas caused by susceptible organisms
• yaws and other non-venereal treponematoses
• impetigo caused by Streptococcus pyogenes
tropical ulcers.

Dosage and administration

Benzylpenicillin and its repository formulations must be administered parenterally.

The powder for injection should be diluted in “water for injection” in accordance with the manufacturer’s instructions.

Pyodermas:

Adults and children over 12 years: benzylpenicillin 2 million IU i.v. daily in four divided doses for 10-14 days.

Children under 12 years: benzylpenicillin 100 mg/kg i.m. daily in four divided doses for 10-14 days.

Yaws:

Adults: benzathine benzylpenicillin 2.4 million IU in two i.m. injections in a single session.

Children: benzathine benzylpenicillin 1.2 million IU in two i.m. injections in a single session.

Impetigo caused by Streptococcus pyogenes:

Adults and children over 12 years: procaine benzylpenicillin 600000 IU i.m. daily in a single dose for at least 10 days.

Children under 12 years: procaine benzylpenicillin 25000-50000 IU/kg i.m. daily in a single dose for at least 10 days.

Tropical ulcers:

Adults and children over 12 years: procaine benzylpenicillin 600000 IU i.m. daily in a single dose for 2-4 weeks.

Children under 12 years: procaine benzylpenicillin 25 000-50 000 IU/kg i.m. daily in a single dose for 2-4 weeks.

Contraindications

Known hypersensitivity to penicillins or cefalosporins.

Precautions

Facilities should be available for treating anaphylaxis whenever penicillins are used. Patients should be questioned carefully about previous allergic reactions before the first dose is administered. If a skin rash develops during treatment, the patient should be transferred to a different class of antibiotic.

Use in pregnancy

There is no evidence that benzyl-penicillin or its repository formulations are teratogenic. They may be used during pregnancy.

Adverse effects

Hypersensitivity reactions range in severity from skin rashes to immediate anaphylaxis.

Pain and sterile inflammation can occur at the site of intramuscular injection; phlebitis or thrombophlebitis sometimes follows intravenous administration of benzylpenicillin. Accidental injection into a peripheral nerve causes severe pain and dysfunction.

Rapid intravenous administration of large doses of benzylpenicillin may cause hyperkalaemia, dysrhythmias and cardiac arrest, particularly in patients with impaired renal function. Accidental intravascular administration of procaine benzylpenicillin or benzathine benzylpenicillin may produce convulsions.

Unduly high concentrations of benzylpenicillin in the brain can result in confusion, convulsions, coma and fatal encephalopathy. The procaine component has been implicated in acute mental disturbances associated with the administration of large single doses.

Interstitial nephritis, neutropenia and thrombocytopenia have been reported.

Overdosage

Overdosage can cause convulsions, paralysis and even death.

Emesis and gastric lavage may be of value if begun within a few hours of injection. Excessive blood concentrations can be lowered by haemodialysis.

Storage

Powder for injection should be stored in vials at 2-8 °C.

to previous section
to next section
 
 
The WHO Essential Medicines and Health Products Information Portal was designed and is maintained by Human Info NGO. Last updated: October 29, 2018