Procaine benzylpenicillin

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Procaine benzylpenicillin
Combination of
Benzylpenicillinantibiotic
Procaineanaesthetic
Clinical data
AHFS/Drugs.comMonograph
ATC code
Legal status
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CAS Number
ChEMBL
E numberE707 (antibiotics) Edit this at Wikidata
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ECHA InfoCard100.000.187 Edit this at Wikidata
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Procaine benzylpenicillin (rINN), also known as procaine penicillin, is an antibiotic useful for the treatment of a number of bacterial infections.

It is a form of penicillin which is a combination of benzylpenicillin and the local anaesthetic agent procaine. Following deep intramuscular injection, it is slowly absorbed into the circulation and hydrolysed to benzylpenicillin — thus it is used where prolonged low concentrations of benzylpenicillin are required.

This combination is aimed at reducing the pain and discomfort associated with a large intramuscular injection of penicillin. It is widely used in veterinary settings.

It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.[1]

Uses

Specific indications for procaine penicillin include:[2]

  • Syphilis
    • In the United States, Bicillin C-R (a injectable suspension which 1.2 million units of benzathine penicillin and 1.2 million units of procaine penicillin per 4 ml) is not recommended for treating syphilis, since it contains only half the recommended dose of benzathine penicillin. Medication errors have been made due to the confusion between Bicillin L-A & Bicillin C-R.[3] As a result, changes in product packaging have been made; specifically, the statement "Not for the Treatment of Syphilis" has been added in red text to both the Bicillin CR and Billin CR 900/300 syringe labels.[4]
  • Respiratory tract infections where compliance with oral treatment is unlikely
  • Alongside Pen V and Erythromycin, Bicillin C-R is used to treat strep throat, given as one IM injection
  • Cellulitis, erysipelas
  • Procaine penicillin is also used as an adjunct in the treatment of anthrax.

Adverse effects

At high doses procaine penicillin can cause seizures and CNS abnormalities due to procaine present in it.

Compendial status

References

  1. ^ "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014.
  2. ^ Rossi S, editor, ed. (2006). Australian Medicines Handbook. Adelaide: Australian Medicines Handbook. ISBN 0-9757919-2-3. {{cite book}}: |editor= has generic name (help)
  3. ^ Centers for Disease Control and Prevention (CDC) (2005). "Inadvertent use of Bicillin C-R to treat syphilis infection—Los Angeles, California, 1999–2004". MMWR Morb. Mortal. Wkly. Rep. 54 (9): 217–9. PMID 15758893.
  4. ^ United States Food & Drug Administration. "FDA Strengthens Labels of Two Specific Types of Antibiotics to Ensure Proper Use." Published December 1, 2004. Last accessed June 18, 2007.
  5. ^ British Pharmacopoeia Commission Secretariat. "Index (BP 2009)" (PDF). Retrieved 26 March 2010. {{cite web}}: Cite has empty unknown parameter: |coauthors= (help)