Benzathine benzylpenicillin, also known as benzathine penicillin G (BPG), is an antibiotic medication useful for the treatment of a number of bacterial infections.[3] Specifically it is used to treat strep throat, diphtheria, syphilis, and yaws.[3][4] It is also used to prevent rheumatic fever.[4] It is given by injection into a muscle.[3][4] It is known as "Peanut Butter Shot" in US military slang due to its appearance.[5]
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Benzylpenicillin | antibiotic |
Benzathine | stabilizer |
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Trade names | Bicillin L-A,[1] Permapen, others |
Other names | penicillin benzathine benzyl, benzathine penicillin, penicillin G benzathine, benzylpenicillin benzathine[2] |
AHFS/Drugs.com | Professional Drug Facts |
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Routes of administration | Intramuscular injection[3] |
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E number | E708 (antibiotics) |
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ECHA InfoCard | 100.014.782 |
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Side effects include allergic reactions including anaphylaxis, and pain at the site of injection.[4] When used to treat syphilis a reaction known as Jarisch-Herxheimer may occur.[4] It is not recommended in those with a history of penicillin allergy or those with syphilis involving the nervous system.[4][3] Use during pregnancy is generally safe.[3] It is in the penicillin and beta lactam class of medications and works via benzylpenicillin.[3][4] The benzathine component slowly releases the penicillin making the combination long acting.[6]
Benzathine benzylpenicillin was patented in 1950.[2][7] It is on the World Health Organization's List of Essential Medicines.[8]
It is used to treat strep throat, diphtheria, syphilis, and yaws.[3][4]
A single large 1.2-million-unit dose of intramuscular BPG is given to US military recruits. The Army in particular has a policy to inject all recruits if not allergic, though supply issues and individual base choices have reduced the coverage. A retrospective analysis shows that it reduces the rate of all-cause acute respiratory disease by 32% among Army recruits.[9]
The possible adverse effects are generally similar to other forms of penicillin. BPG is overall well-tolerated, but pain from the injection site is a common concern.[10]
It is in the penicillin class of medications. It is slowly absorbed into the circulation, after intramuscular injection, and hydrolysed to benzylpenicillin in vivo. It is the drug-of-choice when prolonged low concentrations of benzylpenicillin are required and appropriate, allowing prolonged antibiotic action over 2–4 weeks after a single IM dose.[citation needed]
It is marketed by Pfizer (formerly by Wyeth) under the trade name Bicillin L-A.[11]