Benzylpenicillin
General Information
A penicillin antibiotic. Do NOT use if patient is allergic to penicillin.
Formulary antimicrobial: Use in accordance with Trust guidelines
AWaRe antibiotic classification: 'Access'. Use as per guidelines.
For all information regarding interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).
Dosing
| Intravenous benzylpenicillin | |
| Standard dose | 1.2g QDS |
| Severe infection |
Dose can be increased up to 14.4g per day in 4-6 divided doses (e.g. 2.4g every 4 hours or 3.6g every 6 hours) |
Obesity
Dosing for penicillins should be at the upper end of recommended ranges, particularly for morbidly obese patient with severe infections, considering patient’s renal function.
Renal and hepatic impairment
Renal impairment
|
eGFR (mL/min/1.73m2) |
Intravenous benzylpenicillin |
|
More than 20 |
No adjustment |
|
10-20 |
600mg - 2.4g QDS depending on severity of infection |
|
Less than 10 |
600mg – 1.2g QDS depending on severity of infection. Maximum dose in severe renal impairment 4.8g per day |
|
HD/HDF/High Flux/PD |
600mg – 1.2g QDS depending on severity of infection. Maximum dose 4.8g per day HD/HDF/High Flux/PD: Dialysed; give after dialysis |
Hepatic impairment
Reduce dose to 300mg TDS, if advanced liver disease is associated with severe renal failure.
References
- Benzylpenicillin Sodium 600 mg powder for solution for injection / infusion [online]. Manufacturer - Sandoz Limited – last updated: 2022 Aug 24. Accessed via: www.emc.medicines.org.uk [Accessed 2023 Aug 24].
- The Renal Drug Database. Benzylpenicillin - last updated: 2019 Sep 9. Accessed via: https://renaldrugdatabase.com [Accessed 2023 Aug 21].
- UK Medicines Information. How should antibiotics be doses in obesity – last updated 2017 Mar 1. Accessed via: https://www.gloshospitals.nhs.uk/media/documents/Obese_Dosing_2016_update.pdf [Accessed 2022 Nov 23].