Permapen (Penicillin G Benzathine) - Summary

PERMAPEN SUMMARY

PERMAPEN® ISOJECT®
(Penicillin G Benzathine)
Injectable Suspension
1,200,000 units
For lntramuscular Use Only

Permapen® (Penicillin G Benzathine) Injectable Suspension, a sterile antibacterial agent, is a repository penicillin compound which provides blood levels for long periods following its intramuscular injection. This property is the result of its extremely low solubility in water. Each milliliter contains 600,000 units of penicillin G benzathine; 0.006 grams sodium citrate; 0.003 grams polyvinylpyrrolidone; 0.010 grams lecithin, and 0.003 grams sodium carboxymethylcellulose in an aqueous suspension. Permapen also contains methylparaben 0.09% and propylparaben 0.01% as preservatives.

Intramuscular penicillin G benzathine is indicated in the treatment of infections in both children and adults due to penicillin G-susceptible microorganisms that are susceptible to the low and very prolonged serum levels common to this particular dosage form in the indications listed below. Therapy should be guided by clinical response.

Note: When high sustained serum levels are required, injectable penicillin G either IM or IV should be used.

The following infections will usually respond to adequate dosages of intramuscular penicillin G benzathine:

Upper Respiratory Tract (pharyngitis): streptococci (group A – without bacteremia).

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.

See all Permapen indications & dosage >>

NEWS HIGHLIGHTS

Published Studies Related to Permapen (Penicillin)

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.

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Clinical Trials Related to Permapen (Penicillin)

Bicillin L-A vs Placebo for the Treatment of Chronic, Plaque-Type Psoriasis Unresponsive to Topical Medications [Recruiting]
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.

Amoxicillin Versus Benzyl Penicillin for Treatment of Children Hospitalised With Severe Pneumonia [Recruiting]
This study seeks to determine whether clinical outcome following initial treatment of severe pneumonia with oral amoxicillin is as effective as the current standard benzyl penicillin. The study will also provide an estimate of the proportion of Kenyan children with severe pneumonia who fail treatment with a single antibiotic.

Simplified Antibiotic Therapy for Sepsis in Young Infants [Recruiting]
This trial evaluates primary care clinic-based simplified antibiotic therapy options for young infants, 0-59 days old in high neonatal mortality settings in peri-urban Karachi where hospital referral is frequently refused by families.

A Pilot Study Evaluating Penicillin G and Ceftriaxone as Therapies for Presumed Neurosyphilis in HIV Seropositive Individuals [Completed]
To provide information on the response of HIV infected, neurosyphilis patients to the currently recommended treatment for neurosyphilis; to determine whether possible co-infection with both HIV and syphilis makes more difficult the diagnosis of syphilis; to explore the usefulness of an alternative treatment which, if effective, would permit outpatient treatment for neurosyphilis that until now required prolonged hospitalization.

Studies suggest that syphilis treatment failures may be more common in HIV infected patients than in patients without HIV infection and that treatment failures occur due to and/or are displayed as central nervous system (CNS) involvement. Very little is known about the best treatment course for neurosyphilis in patients who are also infected with HIV.

Azithromycin/Bicillin Syphilis [Active, not recruiting]
The purpose of this study is to determine if Azithromycin, a drug approved for treatment of other infections, is as affective for syphilis therapy is as the usual treatment. Approximately 600 healthy adults, who are HIV-negative, age 18 to 55 years of age with primary, secondary or early latent syphilis, will be participating in this research study. Volunteers will be enrolled in 4 cities of the United States and in Madagascar. Participants will be chosen randomly (by chance) to receive one of 2 study drugs: Benzathine Penicillin given as one dose (2 shots in the buttocks) or 4 tablets of Azithromycin. Over 2 years, 10 visits are required. Procedures will include blood samples, physical exam, and swabs of sores. For subjects who report history of Penicillin allergy will be given either 2. 0 g of oral Azithromycin or 100 mg Doxycycline taken orally, twice a day for 14 days.

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PATIENT REVIEWS / RATINGS / COMMENTS

Permapen review by 56 year old female patient
		Rating
Overall rating:
Effectiveness:		Highly Effective
Side effects:		Extremely Severe Side Effects
		Treatment Info
Condition / reason:		tooth infection
Dosage & duration:		500mg taken twice a day for the period of 2 days
Other conditions:		none
Other drugs taken:		none
		Reported Results
Benefits:		the pain in my tooth started to subside
Side effects:		I went into shock. My tongue swelled up, my face got very swollen. My heart was racing and I started to sweat something terrible. I was told that I was lucky not to die from taking this medication.
Comments:		I was rushed to the doctors office and given another drug to counter the effects of the penicillin. I was sick from the whole episode for a very long time. I am never suppose to take penicillin again or any drug that is a derivative of penicillin.

Permapen review by 20 year old female patient
		Rating
Overall rating:
Effectiveness:		Ineffective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		Viral Bronchitis
Dosage & duration:		250mg taken 3 x day for the period of 10 days
Other conditions:		None
Other drugs taken:		none
		Reported Results
Benefits:		Absolutely no benefits, did not seem to get better even in a week. Through research I learned that penicillin does not treat a virus and that a virus must run its course. No idea why my doctor precribed Penicillin. Would rather he had been on the up and up about it instead of precribing a worthless treatment.
Side effects:		No side effects at all, just took an antibiotic I did not need and do not see any health benefit in that at all
Comments:		Doctor diagnosed me with Viral Bronchitis after and xray. He then prescribed Penicillin to treat it. Worthless treatment, since Penicillin is totally ineffective to fight a virus.