In this article, we will discuss Penicillin-Dosage (Part-II). So, let’s get started.
Penicillin
Cloxacillin 50-100 mg/kg/day IV or oral (1 hr before or 2 hr after food) for staphylococcal infection. 200 mg/kg/day q 4hr for meningitis (maximum dose 4 g/day).
Adult dose: 250-500 mg q 6 hr oral or IV.
(Klox, bioclox, clopen, cloxacillin, aclox caps 250 and 500 mg; syrup 125 mg per 5 ml; novaclox, clamp cap containing cloxacillin 250 mg, ampicillin 250 mg; duoclox syrup contains ampicillin 125 mg and cloxacillin 125 mg; ampilox LB syrup containing ampicillin 125 mg, clox 125 mg and Lactobacillus sporogenes 60 million; inj klox, bioclox 250 mg, 500 mg per vial).
Penicillin G aqueous 100,000-200,000 units/kg IV (over 15-30 minutes), IM q 4-6 hr. For severe infections like meningitis and endocarditis, 2,50,000-4,00,000 units IV, IM q 4 hr (not to exceed 12 million units per day). For prophylaxis of rheumatic fever and pneumococcal infections, 200,000 units (125 mg) twice a day. Administer 30 minutes before or 2 hours after meals. Neonates 50,000-1,00,000 units/kg/day in 2 divided doses, 1-2 lakh units/kg/day in 2 divided doses in case of meningitis.
Adult dose: 200,000-400,000 units q 8 hr or 800,000 units q 12 hr.
Caution: Sodium and potassium content is 1.68 mEq of cation per million units, large bolus injections may cause seizures.
C/I: Hypersensitivity to penicillin.
(Pentids tabs 2,00,000 units (125 mg), 4,00,000 units, 8,00,000 units; inj benzyl penicillin 5,00,000–10,00,000 units per vial).
Penicillin G benzathine 0.6 mega units IM 3 weekly below 6 years of age and 1.2 mega units IM every 3 weeks after 6 years of age for secondary prophylaxis against rheumatic fever.
(Penidure LA 6, LA 12, LA 24; benzathine penicillin G;pencom, longacillin 0.6 million, 1.2 million, 2.4 million units per vial).
Penicillin V (phenoxymethyl penicillin) Infants 62.5-125 mg/dose, children <5 yrs 125 mg/dose, 6-12 yrs 250 mg/dose administered q 6 hr 30 minutes before or 2 hr after food. For rheumatic prophylaxis, 250 mg orally twice daily. 250 mg is equivalent to 4,00,000 units.
(Kaypen tabs 125 mg, 250 mg penivoral tabs 55 mg, 130 mg).
Piperacillin 200-300 mg/kg/day q 4 to 6 hr IV, IM.
Adult dose: 344 gm every 4-6 hr.
C/I: Infectious mononucleosis, penicillin or cephalosporin allergy
(Inj piprapen, pipracil 1.0 g, 2.0 g, 4.0 g vials).
Piperacillin with tazobactam 300–400 mg/kg/day q 6-8 hr. Broad spectrum antibiotic active against Gram-positive and Gram-negative aerobic and anaerobic bacteria.
Adult dose: 4-5 g by slow IV injection or infusion q 8 hr.
(Inj zosyn, tazact, piptaz, tazopip containing piperacillin 4 g, tazobactam 500 mg).
Procaine penicillin G 25,000-50,000 units/kg/day single dose IM. Neonates 50,000 units/kg/day IM.
(Inj procaine penicillin 4,00,000 units per vial).
Ticarcillin with clavulanic acid 200-300 mg/kg/day of ticarcillin q 6-8 hr IV over 15-30 minutes or IM.
Adult dose: 1 vial (3 g ticarcillin) 4-6 hr by IV infusion.
(Inj timentin, ticarnic, cidal, megacillin, tacidal, pzobact 3.1 g contains ticarcillin 3 g + clavulanate 100 mg).