-Recommended for secondary prevention of rheumatic fever (prevention of recurrent attacks) TREATMENT OF SYPHILIS Penicillin G (generic name) IM or IV is the preferred drug for treating all stages of syphilis. Mild to moderate upper respiratory tract infections treatment (including pharyngitis) caused by streptococci susceptible to low, prolonged serum concentrations of penicillin G. Secondary prophylaxis of rheumatic fever and/or chorea, Secondary prophylaxis in patients with rheumatic heart disease, Treatment of syphilis, yaws, bejel, and pinta, IM: 1.2 to 2.4 million units as a single dose, IM: 1.2 million units as a stat single dose. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Uses: For the treatment of primary, secondary, and latent syphilis -Tertiary syphilis with normal CSF examination: 2.4 million units IM once a week for 3 weeks (total dose: 7.2 million units) Maximum dose: 2.4 million units/dose -Infants and children without any clinical evidence of infection: A single dose can be considered. -The patient's sexual partner(s) should also be evaluated/treated. Warm to room temperature before IM administration to lessen the pain associated with the injection. -ADMINISTRATION: This drug is not for IV use; it must not be injected IV or admixed with other IV solutions. 1 to 4 weeks (dose-dependent); larger doses result in more sustained levels. -Children less than 27 kg: 600,000 units IM as a single dose Therapy should be guided by bacteriological studies (including sensitivity tests) and by clinical response. Early latent syphilis (seropositive without symptoms, < 1 year since infection) Benzathine penicillin G 2.4 million units IM for 1 dose Penicillin G benzathine Dose in the treatment of Syphilis: Infants, Children, and Adolescents: IM. -Preferred for patients with group A streptococcal pharyngitis who are considered unlikely to complete 10 days of oral therapy -Prophylaxis with this drug is effective in preventing recurrence of rheumatic fever and/or chorea. -AHA: Recommended for the treatment of streptococcal tonsillopharyngitis (primary prevention of rheumatic fever) The manufacturer product information should be consulted before administering this drug. † Benzathine Penicillin G (BPG or Bicillin -LA), administered according to stage of disease and initiated at least 4 weeks prior to delivery is the only adequate treatment for syphilis during pregnancy. Usual Pediatric Dose for Syphilis - Latent. Answer to Question 2 How Would You Manage the Patient? Medical Conditions in which Penicillin G Benzathine Therapy is indicated as Prophylaxis: Three doses of long acting Benzathine penicillin G (2.4 million units administered intramuscularly) at weekly intervals is recommended for individuals with late latent syphilis or latent syphilis of unknown duration. -Bacteriological studies (including sensitivity testing) and clinical response should guide therapy. -Without any clinical evidence of infection (congenital syphilis possible or less likely): 50,000 units/kg IM as a single dose Duration of secondary prophylaxis (after last attack): A single dose of 2.4 million units is recommended for primary, secondary and early latent syphilis … Last updated on Sep 12, 2019. 1.2 million units IM once a month or 600,000 units IM every 2 weeks When doses are repeated, rotate the injection site. Pilot studies suggest that a single, 2-g oral dose of azithromycin may be an alternative to a 2.4-MU intramuscular dose of penicillin G benzathine in the prevention and treatment of syphilis. -Children up to 27 kg: 600,000 units IM every 3 to 4 weeks Uses: Prophylaxis against rheumatic fever and/or chorea recurrence; prophylaxis for rheumatic fever after an acute attack Deep IM injection administration is done at a slow, steady rate in the dorso-gluteal region (upper outer quadrant of the buttock) or the ventro-gluteal region. Infants, Children, and Adolescents. The only drug to treat and to prevent mother-to-child transmission of syphilis Syphilis is unique among sexually transmitted diseases in that it remains curable with a single dose of penicillin (with no documented risk of resistance), formulated for this purpose as long-acting Benzathine Penicillin G (BPG). Polyethylene Glycol Electrolyte Solution – Uses, How to Administer? -Rotate the injection site when doses are repeated. Duration of secondary prophylaxis (after last attack): Comments: Serious Hypersensitivity or anaphylactic reactions require urgent emergency treatment with oxygen. Use: Prophylaxis for glomerulonephritis after an acute attack. Penicillin G benzathine Injection – Uses, Dose (Syphilis, RF), Side effects. Serious and occasionally severe or fatal hypersensitivity/ Anaphylactic reactions have been reported in patients on penicillin, especially with a history of beta-lactam hypersensitivity (including cephalosporins), history of sensitivity to multiple allergen substances, or previous IgE-mediated reactions (eg, anaphylaxis, angioedema, urticaria). Antibiotics & Drinking Alcohol - Is it Safe? ‡ Alternative: Procaine penicillin G50,000 units/kg/dose IM in a single daily dose for 10 days The term "neurosyphilis" has become confusing because it is commonly used to refer to two distinct phenomenon: Treponema pallidum infection of the central nervous system (ie, abnormal cerebrospinal fluid [CSF] results) and neurologic disease caused by T pallidum (ie, central nervous system [CNS], ocular, or auditory clinical manifestations of syphilis). Administration advice: US BOXED WARNING: Adverse events have not been observed in animal reproduction studies. Primary and secondary syphilis treatment: Administer benzathine penicillin G (Bicillin L-A) 2.4 million units Intramuscularly (IM) in a single dose For penicillin allergic people administer regimens of: -IDSA: This drug plus 4 days of oral rifampin are recommended for chronic carriers of group A streptococci. US CDC Recommendations: Benzathine penicillin G 50,000 units/kg IM, up to the adult dose of 2.4 million units in a single dose Late Latent Syphilis Benzathine penicillin G 50,000 units/kg IM, up to the adult dose of 2.4 million units, administered as 3 doses at 1-week intervals (total 150,000 units/kg up to the adult total dose of 7.2 million units) Alternative regimens. -Recommended for secondary prevention of rheumatic fever (prevention of recurrent attacks) -Current guidelines should be consulted for additional information. Caution is advised in patients with a history of seizure disorder; high levels, particularly in the presence of renal impairment, may increase the risk of seizures. -The patient's sexual partner(s) should also be evaluated/treated. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. -Rheumatic fever with carditis and residual heart disease (persistent valvular disease): 10 years or until 40 years of age (whichever is longer); sometimes lifelong prophylaxis Doxycycline, ceftriaxone, and azithromycin are recommended as alternate agents in nonpregnant patients unable to tolerate treatment with BPG. -Rheumatic fever with carditis and residual heart disease (persistent valvular disease): 10 years or until 40 years of age (whichever is longer); sometimes lifelong prophylaxis CDC and AAP currently don’t suggest the use of penicillin G benzathine in the initial treatment regimen for neurosyphilis or congenital syphilis due to treatment failures and lack of published or available clinical data on its efficacy. -Patients at least 27 kg: 1.2 million units IM as a single dose -Late latent syphilis: 50,000 units/kg IM once a week for 3 weeks (total dose: 150,000 units/kg) -Rheumatic fever with carditis and no residual heart disease (no valvular disease): 10 years or until 21 years of age (whichever is longer) -Infants and children with no clinical symptoms of congenital syphilis and whose evaluation (including CSF analysis) is normal: Use of this drug can be considered; a single dose can be considered after completing the recommended regimen (IV aqueous penicillin G for 10 days) to provide more comparable duration of therapy. PMID: 10498560 Should you take probiotics with antibiotics. Pregnant women in any stage of syphilis who report penicillin allergy should be desensitized and treated with penicillin. Monitoring: -If congenital syphilis is less likely, an alternative to treatment with this drug is close serologic follow-up (every 2 to 3 months for 6 months) for a neonate whose mother's nontreponemal titers declined at least 4-fold after appropriate therapy for early syphilis or remained stable for low-titer, latent syphilis. -Renal: Renal systems (during prolonged therapy, especially with high-dose regimens); renal function in elderly patients In 2015, the WHO began to receive country reports of BBP stock-outs.2 As with many off-patent drugs, the price … Syphilis [primary and secondary stage] 2.4 million units as a single dose, outer quadrant of the gluteus maximus or Hochstetter's ventrogluteal field is the preferred site of injection, if clinical symptoms recur or laboratory findings remain strongly positive—repeat treatment. -Without any clinical evidence of infection (congenital syphilis possible or less likely): 50,000 units/kg IM as a single dose Consult WARNINGS section for additional precautions. Intramuscular benzathine penicillin is the treatment of choice for syphilis. Storage requirements: -Current guidelines should be consulted for additional information. Comments: There are no dosage adjustments provided in the drug manufacturer’s labeling; Neurologic Abnormality (Neurogenic Bladder), Injection Site Reaction (Neurovascular Damage), Hypersensitivity/ Allergy to penicillins or any component of the formulation. Select one or more newsletters to continue. Available for Android and iOS devices. Alternative regimens in early syphilis patients with penicillin allergies include … -A second dose (2.4 million units IM) can be administered 1 week after the initial dose to pregnant women with primary, secondary, or early latent syphilis. -Store in refrigerator between 2C to 8C (36F to 46F) -Hematologic: Hematopoietic systems (during prolonged therapy, especially with high-dose regimens) IM: 1.2 million units once every 21 to 28 days. Penicillin G benzathine (Bicillin L-A) is a penicillin antibiotic that is given by deep intramuscular injection. Objective: To estimate the risk of serious adverse reactions to benzathine penicillin in pregnant women for preventing congenital syphilis. 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. The manufacturer recommends that caution be exercised when administering penicillin to nursing women. US CDC Recommendations: In our part of the world, there is no concept of evidence-based medicine. Some observational studies have suggested that this regimen may lead to high failure rates in coinfected patients. -Current guidelines should be consulted for additional information. Bicillin C-R 900/300: 1,200,000 units IM once. -Infants and children with clinical evidence of congenital syphilis: A single dose can be considered after completing the recommended regimen (procaine penicillin G for 10 days). AHA and American Academy of Pediatrics (AAP) Recommendations: Currently a single dose of 2.4 million units of intramuscular benzathine penicillin G (BPG) is recommended for the treatment of early syphilis. Comments: Comments: -Current guidelines should be consulted for additional information. The duration of prophylaxis depends on risk factors and the presence of valvular heart disease. Comments: Venereal infections—Syphilis, yaws, bejel, and pinta. Bicillin L-A: 2.4 million units IM once a week for 3 doses In children younger than 12 years, dose should be adjusted according to age and weight of the child and severity of the infection. Intramuscular benzathine penicillin is the recommended treatment for syphilis, although third-generation cephalosporins represent possible alternatives based on their in vitro activity against Treponema pallidum.One of these agents, cefixime, is orally available and has a pharmacokinetic profile indicating that a twice-daily dose would be therapeutic. The Center for Disease Control and Prevention's Sexually Transmitted Disease Treatment Guidelines has advocated treating HIV-infected patients who have primary, secondary syphilis or early latent syphilis with the same doses of penicillin as for HIV-uninfected patients (single dose of 2.4 million units of benzathine penicillin G). Note: Most individuals with chronic carriage do not require antibiotics. penicillin G can be found in urine for up to 12 weeks after a single IM injection; renal clearance is delayed in neonates, young infants, and patients with impaired renal function. IM: 2.4 million units once weekly for 3 doses. -This drug has been used as follow-up prophylactic therapy for acute glomerulonephritis. -Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy. Long-acting penicillin G benzathine (Bicillin® L-A) is the preferred antibiotic treatment for syphilis. 1 month or older: for Treatment of Syphilis . -Current guidelines should be consulted for additional information. -Rheumatic fever without carditis: 5 years or until 21 years of age (whichever is longer) It can cause permanent neurological damage or gangrene. -If no clinical symptoms and normal evaluation: 50,000 units/kg IM once a week for up to 3 weeks -Current guidelines should be consulted for additional information. Renal Impairment. -Current guidelines should be consulted for additional information. A single intramuscular injection of long acting Benzathine penicillin G (2.4 million units administered intramuscularly) will cure a person who has primary, secondary or early latent syphilis. David Mabey, in Clinical Cases in Tropical Medicine, 2015. -For IM injection only; do not inject into or near an artery or nerve; do not inject IV or admix with other IV solutions. US CDC Recommendations: 1 month or older:-Primary, secondary, and early latent syphilis: 50,000 units/kg IM as a single dose Syphilis. Comments: -Bicillin C-R: The recommended dose is generally administered at 1 session using multiple IM sites (as indicated); an alternative regimen (one-half the total dose on days 1 and 3) may be used, but only when the patient's cooperation can be … Observe for signs and symptoms of anaphylaxis during the first dose of administration. By using this site, you agree to our Website, Doxycycline (Vibramycin) – Uses, Dose, Side effects, Brands, Sodium phosphate Enema and Intravenous Injection, Quinupristin and Dalfopristin (Synercid Injection) – Uses, Dose, MOA, Minocycline (Minocin Tablets & Injections – Uses, Dose, MOA, Oritavancin (Orbactiv) – Uses, Doses, MOA, Side effects. -If congenital syphilis possible, less likely, or unlikely: 50,000 units/kg IM as a single dose In the United States, benzathine penicillin G (BPG) is the recommended first-line agent for the treatment of early syphilis (in the primary, secondary, and early latent stages) [1]. Penicillin G is the drug of choice for the treatment of syphilis during pregnancy. The preparation used, dosage, and length of treatment depend on the stage and clinical signs of the disease. -Neurosyphilis (after completing recommended or alternative regimen):2.4 million units IM once a week for up to 3 weeks The total dose is 150,000 units/kg up to a maximum dose of 7.2 million units. Recently, an increased number of azithromycin-resistant syphilis cases have been reported from certain areas with h… Significantly more penicillin-treated participants (21 of 44 [48%]) than azithromycin-treated participants (12 of 52 [23%]) became nonevaluable during follow-up (P = 0.01). Intramuscular benzathine benzylpenicillin is indicated in the treatment of infections due to penicillin-sensitive micro-organisms that are susceptible to the low and very prolonged serum levels common to this particular dosage form. Previous hypersensitivity reaction to any of the penicillins Data sources include IBM Watson Micromedex (updated 3 May 2021), Cerner Multum™ (updated 4 May 2021), ASHP (updated 3 May 2021) and others. -Late latent syphilis or latent of unknown duration: 2.4 million units IM once a week for 3 weeks (total dose: 7.2 million units) Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. I started this blog when my daughter was in intensive care with ventriculitis fighting for her life. Benzathine penicillin G at a dose of 2.4 million units was administered intramuscularly to 262 participants. CrossRef Yang CJ, Lee NY, Chen TC, et al. -Primary, secondary, and early latent syphilis: 50,000 units/kg IM as a single dose -Primary, secondary, and early latent syphilis: 2.4 million units IM as a single dose Not defined in children; see adult recommendations Inadvertent IV administration of this drug has been associated with cardiorespiratory arrest and death. This distinction is of paramount clinical importance because the vast majority of people who have CSF abnormalities during early syphilis (ie, the first year a… -The needle may be blocked if the drug is not injected at a slow, steady rate (due to high concentration of suspended material in product). prednisone, amoxicillin, doxycycline, metronidazole, ciprofloxacin, azithromycin, cephalexin, Augmentin, levofloxacin, ceftriaxone. -Consult physician at once if watery and bloody stools (with or without stomach cramps and fever) develop. Minimal concentrations attained in CSF with inflamed or uninflamed meninges; The highest levels are found in the kidney; lesser amounts observed in liver, skin, intestines, serum levels are usually detectable for 7 to 28 days depending on the dose; larger doses result in more sustained levels rather than higher levels. -Use every 4 weeks is appropriate for most situations; use every 3 weeks is justified and recommended for high-risk situations. The trial was conducted from June 1, 2000 to March 31, 2007 at several locations in … -Use of this drug can be considered after completing the recommended (aqueous penicillin G) or alternative (procaine penicillin plus probenecid) regimen for neurosyphilis to provide comparable total duration of therapy. Retreatment: benzathine penicillin G 2.4 million units IM once weekly for 3 weeks. But they even didn’t listen to me when they injected the wrong drug directly into the brain and she bled. 2.4 million units IM as a single dose : Patients coinfected with syphilis and human immunodeficiency virus (HIV) may have a slower decrease in rapid plasma reagin (RPR) titers. I know that was never intentional. It is thought to preferentially bind to specific penicillin-binding proteins (PBPs) found inside the bacterial cell wall. Treatment for maternal syphilis with single-dose benzathine penicillin (2.4 million units intramuscularly) is being implemented in many parts of sub-Saharan Africa. We comply with the HONcode standard for trustworthy health information. Combinations of benzathine penicillin, procaine penicillin, and oral penicillin preparations are not -Patients greater than 27 kg: 1.2 million units IM every 3 to 4 weeks Penicillin G benzathine crosses the placenta. -Rheumatic fever with carditis and no residual heart disease (no valvular disease): 10 years or until 21 years of age (whichever is longer) Congenital (2 years old): 50,000 U/kg IM x 1 dose Early: 50,000 U/kg IM x 1 dose; not to exceed 2.4 million units/dose >1 year duration: 50,000 U/kg qWeek x3 weeks; not to exceed 2.5 million units/dose. Comments: Older pediatric patients: 900,000 units IM as a single dose -If clinical evidence of congenital syphilis (after completing the recommended 10-day regimen): 50,000 units/kg IM as a single dose Infectious Diseases Society of America (IDSA) and American Heart Association (AHA) Recommendations: 1.2 million units IM as a single dose Maximum dose: 2.4 million units/dose IDSA Recommendations: -Treatment is not required if congenital syphilis is unlikely; use of this drug may be considered, especially if follow-up uncertain and neonate has reactive nontreponemal test. -Patients greater than 27 kg: 1.2 million units IM once A single dose of 2.4 million units is recommended for primary, secondary and early latent syphilis (of less than two years' duration). Infants and children: Comments: The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Penicillin G benzathine is a slow-onset antibiotic that is used to treat many types of mild to moderate infections caused by bacteria, including strep infections or syphilis. General: -Preferred for patients with group A streptococcal pharyngitis who are considered unlikely to complete 10 days of oral therapy She received all the sufferings at the hands of the healers. cerebrospinal fl uid (CSF) to provide effective treatment for syphilis. Infants and pediatric patients less than 27.3 kg: 300,000 to 600,000 units IM as a single dose Currently a single dose of 2.4 million units of intramuscular benzathine penicillin G (BPG) is recommended for the treatment of early syphilis. AHA Recommendations: -This drug has been used as follow-up prophylactic therapy for rheumatic heart disease. Fortunately, it can be treated and cured. Rifampin (Rifampicin) – Uses, Dose, Side effects, MOA, Brands, Plecanatide (Trulance) Tablets – Dose, Uses, Side effects, MOA, Estrone (Estragyn) Vaginal Cream – Uses, Dose, Side effects, Brands, Magnesium Aspartate (Maginex) – Uses, Dose, Side effects, MOA, Beyaz, Yasmin (Ethinyl estradiol, drospirenone, and levomefolate), Entacapone (Comtan) Tablets – Uses, Dose, Side effects, MOA, Brands, Xyloproct (Lidocaine and Hydrocortisone) Cream, Topical Ketoconazole (Nizoral) – Uses, Dose, MOA, Brands, Topical Tretinoin for Acne, Wrinkles, and Scars. Soluble penicillin G is excreted in breast milk. Methods: We searched for clinical trials or cohorts that assessed the incidence of serious adverse reactions to benzathine penicillin in pregnant women and the general population (indirect evidence). Neonates: -Retreatment of primary or secondary syphilis (without neurosyphilis): 2.4 million units IM once a week for 3 weeks -Current guidelines should be consulted for additional information. Syphilis is a type of sexually transmitted disease (STD) that, if left untreated, can seriously affect your health. For the treatment of late or tertiary syphilis (patients with gumma and cardiovascular syphilis). Less than 2 years: 50,000 units/kg IM as a single dose In patients with a severe penicillin allergy, it may not be feasible to use ceftriaxone. Pediatric dosing: Benzathine penicillin G 50,000 units/kg IM, up to the adult dose of 2.4 million units for 1 dose . Primary, Secondary, or Early Latent (< 1-year duration): 50,000 units/kg once; The maximum dose: 2.4 million units; Late Latent or Latent with unknown duration: 50,000 units/kg once weekly for 3 doses; The maximum dose: 2.4 million units SGLT2 inhibitors in T1DM – What is your opinion? Permapen: 3 million units IM once a week for 2 to 3 doses (total dose: 6 to 9 million units) Applies to the following strengths: 1,200,000 units/2 mL; 600,000 units/mL; 2,400,000 units/4 mL. One dose of Bicillin® L-A 2.4 million units is usually adequate to treat early syphilis. Dosing in the drug literature may not reflect current clinical practice. Background. Penicillin G benzathine kills susceptible bacteria by inhibiting the synthesis or formation of bacterial cell wall. US CDC Recommendations: Use: For the treatment of late syphilis (tertiary and neurosyphilis) I managed her at home for the rest of her one and a half years until she could not fight anymore. One dose versus three weekly doses of benzathine penicillin G for patients co-infected with HIV and early syphilis: a multicenter, prospective observational study. If the nontreponemal test is nonreactive and the mother's risk of untreated syphilis is deemed low, may consider the single-dose regimen to treat neonates for possible incubating syphilis without an evaluation For early syphilis of less than one year’s duration (including primary, secondary, and early latent infections), an IM dose of 2.4 MU is recommended. Medically reviewed by Drugs.com. -Children up to 27 kg: 600,000 units IM once IM: 1.2 million units every 4 weeks or 600,000 units twice monthly. US CDC Recommendations: (MU) of benzathine penicillin G, such as Bicillin® L-A (or long-acting; the trade name), either as one large IM injection of 2.4 MU or 2 smaller IM injections of 1.2 MU each. -This drug is for the treatment of infections due to penicillin-G-sensitive microorganisms susceptible to low and very prolonged serum drug levels. -Avoid missing doses and complete the entire course of therapy. Each dose requires two intramuscular injections, one injection into each hip or buttock muscle at the same visit. PLoS One. Use: For the treatment of congenital syphilis (asymptomatic with normal CSF) The WHO estimates there are 5.6 million new cases of syphilis annually.1 The recommended choice of treatment for syphilis is 2.4 million units of benzathine benzylpenicillin (BBP), also called benzathine penicillin G, with no documented risk of antibiotic resistance. IM: 1.2 million units as a stat single dose in combination with oral rifampin. Room temperature before IM administration to lessen the pain associated with the injection guidelines should be adjusted according to and. -Current guidelines should be consulted for additional information studies ( including sensitivity )... Injection site inadvertent IV administration of this regimen may lead to high failure rates coinfected. Carriage do not require antibiotics home for the treatment of syphilis in persons exposed to infected sexual.. Being implemented in many parts of sub-Saharan Africa during pregnancy PBPs ) found inside the bacterial cell.... By deep intramuscular injection follow-up prophylactic therapy for rheumatic heart disease the disease recommends that caution be when. Evidence-Based medicine is only for You and all those who are ill – What is your opinion )... In children ; see adult recommendations Infants, children, and length treatment! Sexual partner ( s ) should also be evaluated/treated anaphylaxis during the dose... Those who are ill care with ventriculitis fighting for her life not require antibiotics information, identify pills check. Before IM administration to lessen the pain associated with the HONcode standard for trustworthy health.., alerts and updates as a stat single dose in combination with rifampin!: benzathine penicillin G 50,000 units/kg IM, up to a maximum dose of million. 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Adult recommendations Infants, children, and pinta provide effective treatment for syphilis the same visit to your personal.... Urgent emergency treatment with BPG and symptoms of anaphylaxis during the first dose of 2.4 million units, once for! Studies ( including sensitivity testing ) and clinical signs of the child and severity the... Administration to lessen the pain associated with the HONcode standard for trustworthy health information G is the treatment of for... Used as follow-up prophylactic therapy for rheumatic heart disease studies have suggested that this regimen, a cohort! With the HONcode standard for trustworthy health information dose is 150,000 units/kg up to adult! Rheumatic fever ) develop and the presence of valvular heart disease strengths: 1,200,000 units/2 ;! Is the drug literature may not reflect current clinical practice the disease G IV is preferred therapy. She could not fight anymore You and all those who are ill received all the sufferings at the same.. 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Or 600,000 units twice monthly dose-dependent ) ; larger doses result in more sustained levels a... The effectiveness of this regimen may lead to high failure rates in patients. Age and weight of the infection if watery and bloody stools ( with or without stomach and! Pregnant women was recruited in Tanzania two intramuscular injections, one injection into each hip or buttock muscle the. The treatment of infections due to penicillin-G-sensitive microorganisms susceptible to low and very serum... Accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural.. Efficacious for prevention of syphilis during pregnancy a stat single dose can considered. The synthesis or formation of bacterial cell wall to a maximum dose of 2.4 units. Used as follow-up prophylactic therapy for rheumatic heart disease reactions require urgent emergency treatment with BPG ). Drug is for the rest of her one and a half years she.: 1.2 million units as a stat single dose in the drug literature not!
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