Benzylpenicillin, also known as penicillin G (PenG) or BENPEN, and in military slang "Peanut Butter Shot"is an antibiotic used to treat a number of bacterial infections.
This includes pneumonia, strep throat, syphilis, necrotizing enterocolitis, diphtheria, gas gangrene, leptospirosis, cellulitis, and tetanus.
It is not a first-line agent for pneumococcal meningitis.
Benzylpenicillin is given by injection into a vein or muscle.
Two long-acting forms benzathine benzylpenicillin and procaine benzylpenicillin are available for use by injection into a muscle.
Side effects include diarrhea, seizures, and allergic reactions including anaphylaxis.
When used to treat syphilis or Lyme disease a reaction known as Jarisch–Herxheimer may occur.
It is not recommended in those with a history of penicillin allergy.
Use during pregnancy is generally the penicillin and β-lactam class of medications.
Benzylpenicillin is on the World Health Organization's List of Essential Medicines.
Medical uses
Antimicrobial potency
As an antibiotic, benzylpenicillin is noted to possess effectiveness mainly against Gram-positive organisms.
Some Gram-negative organisms such as Neisseria gonorrhoeae and Leptospira weilii are also reported to be susceptible to benzylpenicillin.
Adverse effects
Adverse effects can include hypersensitivity reactions including urticaria, fever, joint pains, rashes, angioedema, anaphylaxis, serum sickness-like reaction.
Rarely CNS toxicity including convulsions (especially with high doses or in severe renal impairment), interstitial nephritis, haemolytic anaemia, leucopenia, thrombocytopenia, and coagulation disorders.
Also reported diarrhoea (including antibiotic-associated colitis).
Benzylpenicillin serum concentrations can be monitored either by traditional microbiological assay or by more modern chromatographic techniques.
Such measurements can be useful to avoid central nervous system toxicity in any person receiving large doses of the drug on a chronic basis, but they are especially relevant to patients with kidney failure, who may accumulate the drug due to reduced urinary excretion rates.Fossieck B Jr, Parker RH.
Neurotoxicity during intravenous infusion of penicillin.
A review.
J. Clin.
Pharmacol.
14: 504–512, 1974.
Manufacture
The production of benzylpenicillin involves fermentation, recovery and purification of the penicillin.
The fermentation process of the production of benzylpencillin creates the product.
The presence of the product in solution inhibits the reaction and reduces the product rate and yield.
Thus, in order to obtain the most product and increase the rate of reaction, it is continuously extracted.
This is done by mixing the mold with either glucose, sucrose, lactose, starch, or dextrin, nitrate, ammonium salt, corn steep liquor, peptone, meat or yeast extract, and small amounts of inorganic salts.
The recovery of the benzylpencillin is the most important part of the production process because it affects the later purification steps if done incorrectly.
There are several types of techniques used to recover benzyl penicillin: aqueous two-phase extraction, liquid membrane extraction, microfiltration, and solvent extraction.
Extraction is more commonly used in the recovery process.
In the purification step, the benzylpencillin is separated from the extraction solution.
This is normally done by using a separation column.
Synonyms
Penicillin II (old UK nomenclature for naming penicillins)
References
External links
