Benzathine benzylpenicillin
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Benzathine benzylpenicillin, also known as benzathine penicillin G (BPG), is an antibiotic medication useful for the treatment of a number of bacterial infections.[1] Specifically it is used to treat strep throat, diphtheria, syphilis, and yaws.[1][2] It is also used to prevent rheumatic fever.[2] It is given by injection into a muscle.[1][2] It is known as "Peanut Butter Shot" in US military slang due to its viscosity.[3]
Side effects include allergic reactions including anaphylaxis, and the site of injection is notoriously painful.[2] When used to treat syphilis a Jarisch–Herxheimer reaction may occur.[2] It is not recommended in those with a history of penicillin allergy or those with syphilis involving the nervous system.[2][1] Use during pregnancy is generally safe.[1] It is in the penicillin and beta lactam class of medications and works via benzylpenicillin.[1][2] The benzathine component slowly releases the penicillin making the combination long acting.[4]
Benzathine benzylpenicillin was patented in 1950.[5][6] It is on the World Health Organization's List of Essential Medicines.[7]
Medical uses
It is used to treat strep throat, diphtheria, syphilis, and yaws.[1][2]
Chemopreventive
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.[8]
Adverse effects
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Template:See 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.[9]
Society and culture
It is marketed by Pfizer (formerly by Wyeth) under the trade name Bicillin L-A.[10]
Compendial status
References
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