WARNING: NOT FOR INTRAVENOUS USE. DO NOT INJECT INTRAVENOUSLY OR ADMIX WITH OTHER INTRAVENOUS SOLUTIONS. THERE HAVE BEEN REPORTS OF INADVERTENT INTRAVENOUS ADMINISTRATION OF PENICILLIN G BENZATHINE WHICH HAS BEEN ASSOCIATED WITH CARDIORESPIRATORY ARREST AND DEATH. Prior to administration of this drug, carefully read the WARNINGS, ADVERSE REACTIONS, and DOSAGE AND ADMINISTRATION sections of the labeling.
BICILLIN L-A SUMMARY
Bicillin L-A (penicillin G benzathine injectable suspension) is available for deep intramuscular injection. Penicillin G benzathine is prepared by the reaction of dibenzylethylene diamine with two molecules of penicillin G.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Bicillin L-A and other antibacterial drugs, Bicillin L-A should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Intramuscular penicillin G benzathine is indicated in the treatment of infections due to penicillin-G-sensitive microorganisms that are susceptible to the low and very prolonged serum levels common to this particular dosage form. Therapy should be guided by bacteriological studies (including sensitivity tests) and by clinical response.
The following infections will usually respond to adequate dosage of intramuscular penicillin G benzathine:
Mild-to-moderate infections of the upper-respiratory tract due to susceptible streptococci.
Venereal infections Syphilis, yaws, bejel, and pinta.
Medical Conditions in which Penicillin G Benzathine Therapy is indicated as Prophylaxis:
Rheumatic fever and/or chorea Prophylaxis with penicillin G benzathine has proven effective in preventing recurrence of these conditions. It has also been used as follow-up prophylactic therapy for rheumatic heart disease and acute glomerulonephritis.
Published Studies Related to Bicillin L-A (Penicillin G)
Treatment of streptococcal pharyngitis with once-daily amoxicillin versus intramuscular benzathine penicillin G in low-resource settings: a randomized controlled trial. [2011.06]
BACKGROUND: Primary prevention of acute rheumatic fever is achieved by proper antibiotic treatment of group A beta -hemolytic streptococcal (GAS) pharyngitis... CONCLUSION: If compliance is a major issue, a single dose of IM BPG may be preferable for treatment of GAS pharyngitis.
Administration of perioperative penicillin reduces postoperative serum amyloid a response in horses being castrated standing. [2010.07]
OBJECTIVES: To compare postoperative inflammatory responses in horses administered perioperative procaine penicillin and those not administered penicillin using acute phase protein serum amyloid A (SAA) as a marker of inflammation. STUDY DESIGN: Randomized clinical trial. ANIMALS: Stallions (n=50) castrated under field conditions... CONCLUSIONS: Perioperative antimicrobial therapy reduced the postoperative SAA response, suggesting that bacteria were present in the surgical wound and contributed to inflammation after castration. Horses with elevated preoperative SAA concentrations developed infectious complications more often than horses with normal preoperative SAA concentrations. CLINICAL RELEVANCE: Administration of antimicrobials may be important in horses being castrated standing under field conditions. Increased SAA concentrations seem to be an indicator of increased surgical risk in horses and may be useful before elective surgery for planning.
A phase III equivalence trial of azithromycin versus benzathine penicillin for treatment of early syphilis. [2010.06.01]
BACKGROUND: Syphilis remains an important source of morbidity worldwide. Long-acting penicillin is the only therapy currently recommended for syphilis in much of the world. Because of hesitation to use penicillin for fear of anaphylaxis, there is a need for an effective, well-tolerated alternative to penicillin for syphilis therapy... CONCLUSIONS: In this trial, the efficacy of azithromycin at a dosage of 2.0 g administered orally was equivalent to that of benzathine penicillin G for the treatment of early syphilis in persons without HIV infection.
Comparison of ampicillin plus gentamicin vs. penicillin plus gentamicin in empiric treatment of neonates at risk of early onset sepsis. [2010.05]
AIM: We aimed to compare the clinical efficacy of ampicillin (AMP) vs. penicillin (PEN) both combined with gentamicin in the empirical treatment of neonates at risk of early onset neonatal sepsis (EOS)... CONCLUSIONS: AMP and PEN combined with gentamicin have similar effectiveness in the empiric treatment of suspected neonatal EOS.
Evaluation of penicillin G potassium troches in the treatment of minor recurrent aphthous ulceration in a Chinese cohort: a randomized, double-blinded, placebo and no-treatment-controlled, multicenter clinical trial. [2010.04]
CONCLUSIONS: Penicillin G potassium troches are effective in reducing ulcer size and alleviating ulcer pain of the patients in the treatment of a single episode of MiRAU in this Chinese cohort. Few adverse effects were observed with this therapeutic approach. Copyright 2010 Mosby, Inc. All rights reserved.
Clinical Trials Related to Bicillin L-A (Penicillin G)
Bicillin L-A vs Placebo for the Treatment of Chronic, Plaque-Type Psoriasis Unresponsive to Topical Medications [Terminated]
The purpose of this study is to determine the efficacy for Bicillin L-A, administered
intramuscularly in a dose of 2. 4 million units every three (3) weeks, for the treatment of
chronic, plaque-type psoriasis unresponsive to topical medications or when other systemic
therapies are contraindicated.
Penicillin and Metronidazole in Treatment of Peritonsillar Abscess [Completed]
Treatment of peritonsillar abscess varies. To study whether broad spectrum antibiotics are
required in addition to abscess drainage we perform a prospective, double blind,
placebo-controlled, randomised study on 200 adult patients with peritonsillar abscess. 100
patients are given penicillin and metronidazole and 100 patients get penicillin and placebo.
Recovery and recurrence and analyzed.
Evaluation of Skin Testing Reagents for Penicillin Allergy [Completed]
A self- or parent-reported history of penicillin allergy excludes approximately 10% of the
US population from receiving penicillin (Kerr 1994, Kagy, Blaiss 1998, Solensky et al. 2000,
Neugut et al. 2001). Yet approximately 80% of patients labeled as allergic to the
penicillins can safely take these antibiotics without fear of a life-threatening reaction
(Gadde et al. 1993, Macy et al. 1997). The outcomes of this erroneous classification of
patients include unnecessary denial of an effective and well-tolerated class of antibiotics,
which are often the treatment of choice.
The primary aim of skin testing with the Penicillin Skin Test Kit is to identify subjects at
very low risk of developing acute IgE-dependent reactions when given a penicillin or
cross-reacting drug. The negative predictive value (NPV) of skin testing is assessed by oral
challenge with a penicillin.
Penicillin Skin Testing in Patients With History of Allergic Reactions to Betalactams [Completed]
This study aims to compare the readings of skin testing results in patients with suspected
penicillin allergy between in-house penicillin test preparation and commercial available
penicillin testing kit.
Azithromycin/Bicillin Syphilis [Completed]
The purpose of this study is to determine if azithromycin, a drug approved for treatment of
other infections, is as effective for syphilis (a sexually transmitted disease) as the
standard treatment. Approximately 600 healthy adults, who are HIV-negative, ages 18 to 55
years of age, with primary, secondary or early latent syphilis, will participate in this
research study. Volunteers will be enrolled in 5 U. S. cities and in Madagascar. Participants
will be chosen randomly (by chance) to receive 1 of 2 study drugs: benzathine penicillin
given (2 shots in the buttocks) or 4 tablets of azithromycin. Subjects who report a history
of a penicillin allergy will be given either 2. 0 g of oral azithromycin or 100 mg
doxycycline taken orally, twice a day for 14 days. Over 2 years, 10 visits will be required.
Procedures will include blood samples, physical exams, and swabs of sores.
Reports of Suspected Bicillin L-A (Penicillin G) Side Effects
Limb Reduction Defect (4),
Cleft Palate (4),
Phalangeal Agenesis (4),
Patent Ductus Arteriosus (4),
Atrial Septal Defect (4),
Ventricular Septal Defect (4),
NO Adverse Event (4),
Confusional State (2), more >>
Page last updated: 2011-12-09