Adults: upper respiratory tract infections caused by streptococci, venereal diseases - syphilis, prevention of acute relapses of rheumatic fever, endocarditis, glomerulonephritis. Children are given only for the prevention of rheumatic disease and endocarditis.
Composition:
1 vial contains 1,200,000 IU Benzylated benzylpenicillin.
Action:
Β-lactam antibiotic, a long-acting benzylic penicillin derivative. The mechanism of action is based on the inhibition of cell wall biosynthesis. It is sensitive to beta-lactamase. The antimicrobial activity of the in vitro preparation includes streptococcus (with the exception ofEnterococcus), includingStreptococcus pneumoniae, staphylococci (Staphylococcus spp., only beta-lactamase-negative strains),Neisseria gonorrhoeae (only beta-lactamase negative strains),Neiseria meningitidis, Corynebacterium diphtheriae, Bacillus anthracis, Clostridium spp., Actinomyces bovis, Streptobacillus moniliformis, Listeria monocytogenes, Leptospira spp., Treponema pallidum. Resistance to the preparation is demonstrated by penicillin-producing staphylococci (90-95%) of all strains. Benzathine Penicillin is absorbed slowly after intramuscular administration. The maximum concentration of penicillin in the serum occurs after 24 h. The binding to plasma proteins is about 60%. It achieves much lower concentrations in the blood than benzylpenicillin, but it lasts up to 4 weeks. It is mainly excreted in the urine.
Contraindications:
Hypersensitivity to penicillins or other beta-lactam antibiotics. Do not inject into the nerve or blood vessel area (such injection may cause transverse neuritis with permanent paresis or soft tissue necrosis, distal extremities to the injection site, which may sometimes lead to amputation).
Precautions:
A thorough history of hypersensitivity reactions to penicillins, cephalosporins or other allergens should be performed prior to administration, due to the potential for anaphylactic reactions. Caution in patients with renal failure. The occurrence of diarrhea during or immediately after discontinuation of an antibiotic may be a sign of pseudomembranous enteritis - it is recommended to discontinue the preparation and apply appropriate treatment. Prolonged treatment may contribute to excessive development of non-susceptible bacteria or fungi.
Pregnancy and lactation:
The preparation can be given during pregnancy only if clearly necessary. Caution should be exercised when administering the preparation during breast-feeding, as the drug in small amounts is excreted in breast milk.
Side effects:
Arrhythmia, cardiac arrest, neutropenia, eosinophilia, thrombocytopenia, haemolytic anemia, lymphadenopathy, headache, agitation, tremor, drowsiness, confusion, sleep disorders, transverse myelitis, coma, hallucinations, feelings of fear of death (Hoigne syndrome), neuropathy, blurred vision, blindness, breathing disorders up to apnea, hypoxia, nausea, vomiting, pseudomembranous colitis, neurogenic bladder, haematuria, nephropathy, renal failure, painful erection, impotence, increased urea and serum creatinine, profuse sweating, disorder joints, periostitis, exacerbation of arthritis, myolysis, rhabdomyolysis, drop in blood pressure, yeast infection of the genusCandida, pain, redness, irritation at the injection site (after multiple administrations in the same muscle may appear fibrosis and atrophy), allergic symptoms in the form of chills, fever, muscle pains, acute allergic reactions, including anaphylactic shock, symptoms of serum sickness, edema vasomuscular (they are rare and usually affect patients allergic to many allergens or who have bronchial asthma, rhinitis, urticaria), Jarisch-Herxheimer's reaction (due to bacteriology and fever, general breakdown and headache, occurs most often during the treatment of early syphilis), urticaria, pruritus, erythema, generalized dermatitis, transient increase in alkaline phosphatase and aminotransferases.
Dosage:
Only intramuscularly. Adults 1,200,000 IU up to 2,400,000 IU once or in doses given every 1-4 weeks. Do not exceed the daily dose of 2,400,000 IU. Children: 2-3 years, 600,000 IU every 8-14 days; 4-18 PLN 1,200,000 every 14-21 days.
(C)
