Description and indication for use
Benzylpenicillin is an antibacterial,
useful in the treatment of most gram +ve and gram -ve organisms. It is also effective against spirochaetes.
Dose
| Usual dose in neonates | 60 mg/kg/dose |
| GBS Septicaemia | 60 mg/kg/dose |
| GBS Meningitis | 120 mg/kg/dose |
| VLBW | 12 hourly |
| Term | |
Week 1 Weeks 2 to 4 >4 weeks | 12 hourly 8 hourly 4 to 6 hourly |
Reconstitution/Dilution
Vial = 600 mg.
IV:
Add 5.6 mL of water for injection = 100 mg/mL.
IM:
Add 1.6 mL of water for injection = 300 mg/mL.
Route and method of administration
IV:
Doses can be given as a slow bolus over 3
minutes. Do not exceed 300 mg/minute.
Side effects
High doses may cause CNS toxicity including
lethargy, twitching and seizures.
Disturbances to serum electrolytes.
Note: 600mg vial contains 1.7 mmol of sodium.
Incompatibilities
Benzylpenicillin may not be mixed together
with the following drugs: Amphotericin B, heparin sodium (high concentration),
sodium bicarbonate, insulin, phenytoin sodium, vancomycin.
Special considerations
Caution in patients with poor renal function.
Caution in hypernatraemic patients due to high sodium content.
Inactivates aminoglycosides (e.g.
gentamicin), therefore preferably separate doses by an hour. If not possible to
separate doses, flush line well with sodium chloride 0.9% before and after
giving doses.
Drug interactions
Ensure that
gentamicin levels are monitored when used in combination with Benzylpenicillin, especially in
patients with poor renal function.
Nursing responsibilities
Observe for side effects.
References:
1.
RCH Paediatric Pharmacopoeia,
13th ed. 2002.
2.
RWH Neonatal Pharmacopoeia, 2nd
ed. 2005.
3.
RCH Paediatric Injectable Guidelines,
4th ed. 2011.