Benzathine Penicillin Injection

Benzathine Penicillin G is a long-acting form of the antibiotic penicillin, used to treat and prevent a wide range of bacterial infections. It is administered via a deep intramuscular (IM) injection, which allows the medication to be released slowly into the bloodstream over an extended period. This long-lasting effect makes it a valuable treatment for infections that require sustained antibiotic levels, often with a single dose.

Benzathine penicillin G works by inhibiting the synthesis of the bacterial cell wall. It is a type of beta-lactam antibiotic that interferes with the cross-linking of peptidoglycans, a key component of the cell wall. This weakens the cell wall, eventually leading to the death of the bacteria.

This injection is primarily used for:

• Syphilis: It is the first-line treatment for syphilis, especially primary, secondary, and early latent stages.

• Strep Throat: It is effective in treating upper respiratory tract infections caused by susceptible Streptococcus bacteria.

• Rheumatic Fever Prophylaxis: It is crucial for preventing the recurrence of rheumatic fever and rheumatic heart disease in patients with a history of strep infections.

• Other Infections: It is also used to treat infections like yaws, bejel, and pinta.

• Route: Benzathine penicillin is administered as a deep intramuscular injection, typically into the upper outer quadrant of the buttock in adults or the mid-lateral thigh in children.

• Important Warning: This medication should NEVER be given intravenously (into a vein). Inadvertent intravenous administration can lead to serious and potentially fatal side effects, including cardiorespiratory arrest and nerve damage.

• Pain: The injection is often thick and can be very painful. Healthcare providers may warm the vial to room temperature before administration to minimize discomfort.

As with any antibiotic, Benzathine Penicillin G can cause a range of side effects, from common to severe.

• Common Side Effects:

  • Pain, swelling, or redness at the injection site.

  • Nausea, vomiting, or diarrhea.

  • Mild skin rash or itching.

  • Headache.

• Serious Side Effects:

  • Allergic Reactions: Serious and sometimes fatal allergic reactions (anaphylaxis) can occur, especially in individuals with a history of penicillin or cephalosporin allergies. Symptoms include hives, swelling of the face, throat, or tongue, and difficulty breathing.

  • Jarisch-Herxheimer Reaction: In patients being treated for syphilis, a reaction may occur within the first 24 hours of treatment. Symptoms include fever, chills, headache, muscle aches, and worsening of skin sores. This is a sign that the medication is working and killing the bacteria.

  • C. difficile-associated diarrhea (CDAD): This is a serious intestinal condition that can occur during or even months after antibiotic treatment.

  • Neurological Side Effects: In rare cases, especially with very high doses or in patients with kidney problems, neurological symptoms like seizures, confusion, or hallucinations may occur.

• Hypersensitivity: The injection is contraindicated in patients with a history of hypersensitivity to penicillin or other beta-lactam antibiotics.

• Renal Impairment: Caution is advised in patients with kidney disease, as the drug's excretion may be delayed, leading to higher levels in the body.

• Pregnancy and Breastfeeding: While generally considered safe for use during pregnancy, it is always important to consult with a healthcare professional before use.

• Drug Interactions: Benzathine penicillin may interact with certain medications, so it is important to inform the doctor about all other drugs being taken.