Benzyl sodium salt. Directions for use and dosage

Benzylpenicillin sodium salt(benzylpenicillin)

Composition and release form of the drug

Powder for solution for injection white, with a weak characteristic odor.

1 million units - bottles (1) - cardboard packs.
1 million units - bottles (10) - cardboard boxes.
1 million units - bottles (50) - cardboard boxes (for hospitals).

pharmachologic effect

Antibiotic of the group of biosynthetic penicillins. It has a bactericidal effect by inhibiting the synthesis of the cell wall of microorganisms.

Active against gram-positive bacteria: Staphylococcus spp., Streptococcus spp. (including Streptococcus pneumoniae), Corynebacterium diphtheriae, Bacillus anthracis; gram-negative bacteria: Neisseria gonorrhoeae, Neisseria meningitidis; anaerobic spore-forming rods; as well as Actinomyces spp., Spirochaetaceae.

Strains of Staphylococcus spp. that produce penicillinase are resistant to the action of benzylpenicillin. Destroys in an acidic environment.

Benzylpenicillin potassium salt is used only intramuscularly and subcutaneously, in the same doses as benzylpenicillin sodium salt.

Benzylpenicillin novocaine salt is used only intramuscularly. Average therapeutic dose for adults: single - 300,000 units, daily - 600,000 units. Children under 1 year of age - 50,000-100,000 units/kg/day, over 1 year of age - 50,000 units/kg/day. Frequency of administration 3-4 times/day.

The duration of treatment with benzylpenicillin, depending on the form and severity of the disease, can range from 7-10 days to 2 months or more.

Side effects

From the outside digestive system: diarrhea, nausea, vomiting.

Effects due to chemotherapeutic action: vaginal candidiasis, oral candidiasis.

From the side of the central nervous system: When using benzylpenicillin in high doses, especially with endolumbar administration, neurotoxic reactions may develop: nausea, vomiting, increased reflex excitability, symptoms of meningism, convulsions, coma.

Allergic reactions: increased body temperature, urticaria, skin rash, rash on mucous membranes, joint pain, eosinophilia, angioedema. Cases of anaphylactic shock with fatal outcome have been described.

Drug interactions

Probenecid reduces the tubular secretion of benzylpenicillin, resulting in an increase in the concentration of the latter in the blood and an increase in the half-life.

At simultaneous use with antibiotics that have a bacteriostatic effect (tetracycline), the bactericidal effect of benzylpenicillin is reduced.

special instructions

Use with caution in patients with impaired renal function, heart failure, predisposition to allergic reactions (especially with drug allergies), at hypersensitivity to cephalosporins (due to the possibility of developing cross-allergy).

If no effect is observed 3-5 days after the start of use, you should move on to the use of other antibiotics or combination therapy.

Due to the possibility of developing fungal superinfection, it is advisable to prescribe benzylpenicillin when treating antifungal drugs.

It must be taken into account that the use of benzylpenicillin in subtherapeutic doses or early cessation of treatment often leads to the emergence of resistant strains of pathogens.

Pregnancy and lactation

Use during pregnancy is possible only if the expected benefit of therapy for the mother outweighs the potential risk to the fetus.

If it is necessary to use it during lactation, the issue of stopping breastfeeding should be decided.

For impaired renal function

Use with caution in patients with impaired renal function.

| Benzylpenicillinum-sodium

Analogs (generics, synonyms)

Benzylpenicillin sodium

Recipe

S.: Dissolve in a sterile isotonic sodium chloride solution and inject subcutaneously, intramuscularly 4 times a day

Rp.: Benzylpenicillini-natrii 500,000 units

S.: Inject 500,000 units of the drug into the muscle 4 times a day. Pre-dilute it in 2 ml of sterile isotonic sodium chloride solution (child 10 years old)

Rp.: Benzylpenicillini-natrii 250,000 units

S.: Dilute the contents of the bottle in 4 ml of sterile isotonic sodium chloride solution and inject 2 ml (125,000 units) into a vein 2 times with an interval of 3 hours (child 5 years old)

pharmachologic effect

Benzylpenicillin is active against gram-positive microorganisms (staphylococci, streptococci, pneumococci, the causative agent of diphtheria, anaerobic / able to exist in the absence of oxygen / spore-forming bacilli, anthrax bacilli), gram-negative cocci (gonococci, meningococci), as well as against spirochetes, some actinomycetes and others microorganisms. The drug is ineffective against most gram-negative bacteria, rickettsia, viruses, protozoa, and fungi.
Benzylpenicillin, when administered intramuscularly, is quickly absorbed into the blood and is found in body fluids and tissues; penetrates into the cerebrospinal fluid in small quantities. The maximum concentration in the blood is observed after intramuscular injection in 30-60 minutes.

When administered subcutaneously, the rate of absorption is less constant, usually the maximum concentration in the blood is observed after 60 minutes. 3-4 hours after a single intramuscular or subcutaneous injection Only traces of the antibiotic are found in the blood. To maintain concentration high enough to therapeutic effect level, injections must be made every 3-4 hours. When intravenous administration the concentration of penicillin in the blood decreases rapidly. When taken orally, the drug is poorly absorbed and destroyed gastric juice and penicillinase (enzyme) produced by intestinal microflora. It is excreted mainly by the kidneys.
The concentration and duration of circulation of benzylpenicillin in the blood depend on the size of the administered dose. The antibiotic penetrates well into body tissues and fluids. In the cerebrospinal fluid it is normally found in small quantities, but with inflammation meninges its concentration increases.

It should be remembered that strains of staphylococci that produce the enzyme penicillinase, which destroys benzylpenicillin, are resistant to the action of benzylpenicillin. Low activity benzylpenicillin against bacteria intestinal group, Pseudomonas aeruginosa and other microorganisms is also associated to a certain extent with their production of penicillinase.

Mode of application

Benzylpenicillin sodium salt is administered intramuscularly, intravenously, subcutaneously, endolumbarally, intratracheally.

At average severe course diseases (infections lower sections respiratory tract, urinary and biliary tract, soft tissue infection, etc.) - 4-6 million units/day for 4 administrations. In case of severe infections (sepsis, septic endocarditis, meningitis, etc.) - 10-20 million units/day; with gas gangrene - up to 40-60 million units/day.

Daily dose for children under 1 year of age - 50-100 thousand units/kg, over 1 year - 50 thousand units/kg; if necessary - 200-300 thousand units/kg, for "vital" indications - increase to 500 thousand units/kg. The frequency of administration is 4-6 times a day, intravenously - 1-2 times a day in combination with intramuscular injections.
Endolumbarally administered when purulent diseases head and spinal cord and meninges. Depending on the disease and the severity of its course: adults - 5-10 thousand units, children - 2-5 thousand units once a day for 2-3 days intravenously, then prescribed intramuscularly.

For intravenous jet administration, a single dose (1-2 million units) is dissolved in 5-10 ml of sterile water for injection or 0.9% NaCl solution and inject slowly over 3-5 minutes. For intravenous drip administration, 2-5 million units are diluted with 100-200 ml of 0.9% NaCl solution or 5-10% dextrose solution and administered at a rate of 60-80 drops/min. When administered dropwise to children, a 5-10% dextrose solution (30-100 ml depending on the dose and age) is used as a solvent.
Solutions are used immediately after preparation, without allowing other drugs to be added to them.

Subcutaneous injection is used to puncture infiltrates - 100-200 thousand units in 1 ml of 0.25-0.5% procaine solution.
Endolumbar. The drug is diluted in sterile water for injection or in 0.9% NaCl solution at the rate of 1 thousand units/ml. Before injection (depending on intracranial pressure) extract 5-10 ml of CSF and add it to the antibiotic solution in equal proportions.
Inject slowly (1 ml/min), usually once a day for 2-3 days, then proceed to intravenous or intramuscular injections.
In case of suppurative processes in the lungs, a solution of the drug is administered intratracheally (after thorough anesthesia of the pharynx, larynx and trachea). Usually 100 thousand units are used in 10 ml of 0.9% NaCl solution.

For eye diseases ( acute conjunctivitis, corneal ulcer, gonoblennorrhea, etc.) sometimes eye drops containing 20-100 thousand units in 1 ml of 0.9% NaCl solution or distilled water are prescribed. Inject 1-2 drops 6-8 times a day.
For ear drops or nasal drops, solutions containing 10-100 thousand units/ml are used.
Benzylpenicillin potassium salt is administered only intramuscularly and subcutaneously, in the same doses as benzylpenicillin sodium salt.
Benzylpenicillin procaine salt is administered only intramuscularly. Average therapeutic dose for adults: single - 300 thousand units, daily - 600 thousand units. The highest daily dose for adults is 1.2 million units. Children under the age of 1 year are prescribed 50-100 thousand units/kg/day, over 1 year - 50 thousand units/kg/day. The frequency of administration is 1-2 times a day.
The duration of treatment with benzylpenicillin, depending on the form and severity of the disease, is 7-10 days.

Indications

Bacterial infections caused by penicillin-sensitive pathogens: community-acquired pneumonia, pleural empyema, bronchitis; peritonitis; osteomyelitis; infections genitourinary system(pyelonephritis, pyelitis, cystitis, urethritis, cervicitis), biliary tract (cholangitis, cholecystitis); wound infection, skin and soft tissue infections: erysipelas, impetigo, secondary infected dermatoses; diphtheria; scarlet fever; anthrax; actinomycosis; ENT infections; gonorrhea, syphilis.

Contraindications

Hypersensitivity; epilepsy (for endolumbar administration), hyperkalemia, arrhythmias (for potassium salt).

Side effects

From the gastrointestinal tract: stomatitis and glossitis are occasionally observed. Nausea, vomiting. Diarrhea that occurs when antibiotics are prescribed should raise suspicion regarding pseudomembranous colitis (the possibility of the emergence of resistant microorganisms or fungi) and further treatment must be specific for the causative microorganism. If superinfection occurs, appropriate measures should be taken.

Allergic: due attention should be paid to side effects, namely anaphylaxis, urticaria, fever, joint pain, angioedema, erythema multiforme and exfoliative dermatitis.

Infections caused by endotoxin-producing bacteria such as Salmonella, Leptospira or Treponema (treatment for syphilis) may experience a Jarisch-Herxheimer reaction due to bacteriolysis.

Hematological: hemolytic anemia, leukopenia, thrombocytopenia or eosinophilia.

Violation of the pumping function of the myocardium.

Rarely, with pre-existing nephropathy, albuminuria and hematuria may occur. Oliguria or anuria, observed in some cases when benzylpenicillin is prescribed, usually disappears 48 hours after stopping treatment. Diuresis can be restored by administering a 10% mannitol solution.

Release form

In bottles of 125,000 units, 250,000 units, 500,000 units, 1,000,000 units. Ointment (10,000 units in 1 g) 15 g per tube

ATTENTION!

The information on the page you are viewing is created for informational purposes only and does not in any way promote self-medication. The resource is intended to provide healthcare workers with additional information about certain medications, thereby increasing their level of professionalism. Use of the drug "" in mandatory involves consultation with a specialist, as well as his recommendations on the method of use and dosage of the medicine you have chosen.

Most often, antibiotics are administered intramuscularly. Antibiotics for injection are produced in the form of crystalline powder in special bottles. Before use, it is dissolved in a sterile isotonic solution of sodium chloride (saline solution 0.9% sodium chloride), water for injection or 0.25%, 0.5% solution of novocaine, 2% solution of lidocaine.

The most popular is antibiotic PENICILLIN(benzylpenicillin sodium or potassium salt). It is available in bottles of 250,000, 500,000, 1,000,000 units. Dosed in action units.

It is better to dissolve penicillin in a 0.25% or 0.5% solution of novocaine, because it is better retained in the body. In case of individual intolerance to novocaine, use saline solution or water for injection.

There is a rule: For 100 thousand units (0.1 g) of penicillin (benzylpenicillin sodium salt), 1 ml of solvent is taken.

Thus, if the bottle contains 1,000,000 units, then you need to take 10 ml of novocaine.

X =------------------= 10 ml solvent

The penicillin solution cannot be heated, because under the influence of high temperature it is destroyed. Penicillin can be stored in diluted form for no more than a day. Penicillin should be kept in a cool and dark place. Iodine also destroys penicillin, so iodine tinctures are not used to treat the rubber stopper of the bottle and the skin at the puncture site.

Penicillin is administered 4-6 times a day every 4 hours. If the contents of the bottle are intended for one patient, penicillin is diluted randomly with 2-3 ml of novocaine or water for injection (if there is an allergy).

STREPTOMYCIN can be dosed both in grams and in units (units of action). Vials of streptomycin are available in 1.0 g, 0.5 g, 0.25 g. Therefore, in order to dilute it correctly, you need to know TWO RULES:

1.0 gr. corresponds to 1,000,000 units.

0.5 g -"-"- 500000 units.

0.25 g -"-"- 250000 units.

250,000 units of streptomycin are diluted with 1 ml of 0.5% novocaine

500,000 units - 2 ml of 0.5% novocaine

1,000,000 units - 4 ml of 0.5% novocaine _

BICILLIN - antibiotic of prolonged (extended) action. Bicilin - 1, Bicilin - 3, Bicilin - 5. It is produced in bottles of 300,000 units, 600,000 units, 1,200,000 units, 1,500,000 units.

Used as a solvent isotonic solution sodium chloride, water for injection. It is necessary to REMEMBER that 300,000 units take 2.5 ml of diluent

600000 units -"-"- 5 ml

1200000 IU-"-"- 10 ml

1500000 IU-"-"- 10 ml

Rules for performing bicillin injections:

1. The injection is performed as quickly as possible, because the suspension crystallizes. The injection needle should have a wide bore. Air from the syringe should only be released through the needle cone.

2. The patient must be fully prepared for the injection. We dilute carefully in the presence of the patient. When diluting the suspension, there should be no foaming.

3. The suspension is quickly drawn into the syringe.

4. The drug is administered only IM, deep into the muscle , it is better to use the 2-step method in the thigh: before insertion, after puncturing the skin, pull the plunger towards you and make sure that there is no blood in the syringe. Add the suspension.

5. Apply a heating pad to the injection site.

Antibacterial agents

Name

powder for the preparation of solution for injection and local application 500000 units, 1000000 units

Pharmacotherapeutic group

biosynthetic antibiotic penicillin

Tradename

Benzylpenicillin sodium salt

International nonproprietary name

benzylpenicillin

Dosage form

powder for the preparation of solution for injection and topical use.

Compound

Active substance: Benzylpenicillin sodium (benzylpenicillin sodium salt) - 500,000 units and 1,000,000 units.

ATX Code

Pharmacological properties

Pharmacodynamics
Bactericidal antibiotic from the group of biosynthetic (“natural”) penicillins. Suppresses the synthesis of the cell wall of microorganisms. Active against gram-positive pathogens: Staphylococcus spp. (non-penicillinase-forming), Streptococcus spp. (including Streptococcus pneumoniae), Сorynebacterium spp. (including Corynebacterium diphtheriae), Bacillus anthracis, Actinomyces spp.; gram-negative microorganisms: Neisseria gonorrhoeae, Neisseria meningitidis, as well as against Treponema spp., class Spirochaetes. Not active against most gram-negative bacteria (including Pseudomonas aeruginosa), Rickettsia spp., viruses, protozoa. Staphylococcus spp., which produce penicillinase, are resistant to the drug.
Pharmacokinetics
The time required to achieve maximum concentration in blood plasma when administered intramuscularly is 20-30 minutes. Communication with plasma proteins - 60%. Penetrates organs, tissues and biological fluids, in addition to cerebrospinal fluid, eye tissue and prostate gland, during inflammation of the meningeal membranes, it penetrates the blood-brain barrier. It is excreted unchanged by the kidneys. The half-life is 30-60 minutes, with renal failure- 4-10 hours or more.

Indications for use

Bacterial infections caused by penicillin-sensitive pathogens: community-acquired pneumonia, pleural empyema, bronchitis; sepsis, septic endocarditis (acute and subacute), peritonitis; meningitis; osteomyelitis; infections of the genitourinary system (pyelonephritis, pyelitis, cystitis, urethritis, cervicitis), biliary tract (cholangitis, cholecystitis); wound infection, skin and soft tissue infections: erysipelas, impetigo, secondary infected dermatoses; diphtheria; scarlet fever; anthrax; actinomycosis; infections of the ENT organs, eye diseases (acute conjunctivitis, corneal ulcer, etc.); gonorrhea, syphilis.

Contraindications

Hypersensitivity, including to other penicillins, cephalosporins.

Use during pregnancy

The use of the drug during pregnancy is possible only if the expected benefit to the mother outweighs the potential risk to the fetus.
If it is necessary to prescribe the drug during lactation, breastfeeding should be stopped.

Directions for use and doses

Benzylpenicillin and sodium salt are administered intramuscularly, intravenously, subcutaneously, locally.
Intravenously and intramuscularly:for moderate disease (infections of the upper and lower respiratory tract, urinary and biliary tract, soft tissue infections, etc.) - 4-6 million units/day for 4 administrations. For severe infections (sepsis, septic endocarditis, meningitis, etc.) - 10-20 million units/day; with gas gangrene - up to 40-60 million units/day.
The daily dose for children under 1 year of age is 50-100 thousand units/kg, over 1 year of age - 50 thousand units/kg; if necessary - 200-300 thousand units/kg, for “vital” indications - increase to 500 thousand units/kg. Frequency of administration: intramuscularly - 4-6 times a day, intravenously - 1-2 times a day in combination with intramuscular injections.

Subcutaneously for infiltrating infiltrates at a concentration of 100-200 thousand units in 1 ml of 0.25-0.5% procaine solution.

In the cavity (abdominal, pleural, etc.) solution of benzylpenicillin and sodium salt is administered to adults at a concentration of 10-20 thousand units per 1 ml, for children - 2-5 thousand units per 1 ml. Water for injection or 0.9% sodium chloride solution is used as a solvent. The duration of treatment is 5-7 days, followed by switching to intramuscular administration.
For eye diseaseseye drops containing 20-100 thousand units in 1 ml of sterile 0.9% sodium chloride solution or distilled water are prescribed. Administer 1-2 drops 6-8 times a day. The solution is used freshly prepared
For ear drops or nose dropssolutions containing 10-100 thousand units in 1 ml of sterile 0.9% sodium chloride solution or distilled water are used. Administer 1-2 drops 6-8 times a day.
The duration of treatment with benzylpenicillin, depending on the form and severity of the disease, is 7-10 days.

Method of preparing solutions

Solutions are used immediately after preparation, avoiding the addition of other medicines.

For intramuscular administration, add 1-3 ml of water for injection, 0.9% sodium chloride solution or 0.5% procaine (novocaine) solution to the contents of the bottle. The resulting solution is injected deep into the muscle.

When benzylpenicillin a is diluted in a procaine solution, cloudiness of the solution may be observed due to the formation of benzylpenicillin procaine crystals, which is not an obstacle to intramuscular and subcutaneous administration drug.

For intravenous jet administration, a single dose (1-2 million units) is dissolved in 5-10 ml of sterile water for injection or 0.9% sodium chloride solution and administered slowly over 3-5 minutes.

For intravenous drip administration, 2-5 million units are diluted with 100-200 ml of 0.9% sodium chloride solution or 5-10% dextrose solution and administered at a rate of 60-80 drops/min. When administered dropwise to children, a 5-10% dextrose solution (30-100 ml depending on the dose and age) is used as a solvent.

For subcutaneous administration, the contents of the bottle are diluted in a 0.25-0.5% procaine solution: 500 thousand units in 2.5-5 ml, 1 million units in 5-10 ml, respectively.

For intracavitary administration, the contents of the bottle are diluted in 0.9% sodium chloride solution or in water for injection: adults - 500 thousand units in 25-50 ml, 1 million units in 50-100 ml, respectively, children - 500 thousand units in 100-250 ml, 1 million units in 200-500 ml, respectively.
Eye drops should be prepared ex tempore: the contents of the bottle are diluted in a 0.9% solution of sodium chloride or distilled water: 500 thousand units in 5-25 ml, 1 million units in 10-50 ml, respectively.

Release form

Injectable drugs

Release form

Powder for the preparation of solution for injection and local use 50,000 units, 1,000,000 units.
500,000 units and 1,000,000 units each active substance in bottles with a capacity of 10 ml or 20 ml, hermetically sealed with rubber stoppers, crimped aluminum caps or combined aluminum caps with plastic caps.
1, 5, 10 bottles along with instructions for use are placed in a cardboard pack.
50 bottles are placed in a cardboard box with an equal number of instructions for use for delivery to hospitals.

Storage conditions

In a dry place at a temperature of 15 to 25°C. Keep out of the reach of children.

Best before date

3 years. Do not use after the expiration date stated on the package.

S.01.A.A.14 Benzylpenicillin