Penicillin G sodium dosage and administration
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamed Moubarak, M.D. [2]
Dosage and Administration
- Adult patients
- Pediatric patients
This product should not be administered to patients requiring less than one million units per dose. (see PRECAUTIONS - Pediatric Use).
- Renal Impairment
Penicillin G is relatively nontoxic, and dosage adjustments are generally required only in cases of severe renal impairment.
The recommended dosage regimens are as follows:
Creatinine clearance less than 10 mL/min/1.73 m2; administer a full loading dose (see recommended dosages in the tables above) followed by one-half of the loading dose every 8 to 10 hours.
Uremic patients with a creatinine clearance greater than 10 mL/min/1.73m2; administer a full loading dose (see recommended dosages in the tables above) followed by one-half of the loading dose every 4 to 5 hours.
Additional dosage modifications should be made in patients with hepatic disease and renal impairment.
For most acute infections, treatment should be continued for at least 48 to 72 hours after the patient becomes asymptomatic. Antibiotic therapy for Group A β-hemolytic straptococcal infections should be maintained for at least 10 days to reduce the risk of rheumatic fever.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.
- Preparation of Solution
Solutions of penicillin should be prepared as follows: Loosen powder. Hold vial horizontally and rotate it while slowly directing the stream of diluent against the wall of the vial. Shake vial vigorously after all the diluent has been added. Depending on the route of administration, use Sterile Water for Injection, USP, 0.9% Sodium Chloride Injection, USP, or Dextrose Injections, USP.
Note: Penicillins are rapidly inactivated in the presence of carbohydrate solutions at alkaline pH.