| Indicator |
Criteria |
Threshold (%) |
| Indication |
Severe Pneumonia
Pyogenic meningitis (Meningococcal meningitis and Pneumococcal meningitis)
Generalized Neonatal tetanus
Congenital syphilis
Neonatal sepsis
Cellulites
Erysipelas
Endocarditis |
100 |
| Dose and dose frequency |
Bacteremia: 25,000 to 50,000 units/kg/dose IV infusion over 30 minutes, or IM
Severe Pneumonia: 50,000 units/kg/24 hours IV QID
Meningococcal meningitis: 250,000 units/kg/dose IV infusion over 30 minutes, or IM every 4 hour
Pneumococcal meningitis: 250,000 units/kg/dose IV infusion over 30 minutes, or IM every 4 hour
Neonatal sepsis: 50,000 IU/kg/24hours IV QID
Neonatal tetanus: 50,000 IU/kg/24hours IV QID
Cellulites: 50,000 IU/kg/24hours IV 4 hourly
Erysipelas: 50,000 IU/kg/24hours IV
Prevention of Bacterial Endocarditis:50,000 IU/kg intravenously or intramuscularly 30 to 60 minutes before the procedure and, 1 million IU (25,000 IU/kg for children) six hours later
Gonococcus infection (only with proven penicillin-susceptible isolate): 100,000 units/kg/dose IV infusion over 30 minutes, or IM
Congenital syphilis: 50,000 units/kg/dose IV over 30 minutes, given Q 12 hours during the first 7 days of life |
95 |
| Duration |
Congenital syphilis: 10-14 days
Severe Pneumonia: 3 days
Meningococcal meningitis: 10 days
Pneumococcal meningitis: 7 days
Neonatal sepsis: 10 days
Neonatal tetanus: 10 days
Cellulites: 10 days
Erysipelas: until the fever subside
Endocarditis: 2-6 weeks |
90
|
| Contra-indications |
Penicillin hypersensitivity reaction; avoid intrathecal route |
100 |
| Drug interactions |
•Methotrexate,
•Probenecid (decrease renal tubular secretion of the penicillin’s),
•Aminoglycosides (inactivated by high doses of IV benzyl penicillin; should not be administered in same giving set)
|
90 |
|
Outcome
|
Fever reduction
•Decrease of at least 1°C from peak temperature within 3 days of initial crystalline penicillin dose
• Fever not present initially Clinical improvement noted in progress
•New organism or another infection suspected or identified
•Patient discharged before therapy completed and unavailable for follow-up
•Patient expired
Switch to oral therapy |
95 |
|
