b. Usual Dosage. Potassium penicillin G for injection has a short duration of
effect (approximately 60 percent of a total dose is excreted in the urine within a 5-hour
period). Thus, high and frequent doses are required to maintain the elevated serum
levels necessary to treat certain severe infections in individuals with normal kidney
(1) Severe infections due to susceptible strains of streptococci,
pneumococci, and staphylococci--a minimum of 5 million units daily.
Gonorrheal endocarditis--a minimum of 5 million units daily.
(3) Meningococcal meningitis--1 to 2 million units IM every 2 hours or
continuous IV drip of 20 to 30 million units daily.
Actinomycosis--up to 20 million units/day.
Rat-bite fever--12 to 15 million units/day.
Erysipeloid endocarditis--2 to 20 million units/day.
(7) Gram-negative bacillary infections (E. coli, A. aerogenes, A. faecalis,
Salmonella, Shigella, and Proteus mirabilis)--bacteremia--20 to 80 million units/day.
(8) Diphtheria (carrier state)--300,000 to 400,000 units/day in divided doses
for 10 to 20 days.
(9) Anthrax--a minimum of 5 million units of penicillin/day in divided doses
until cure is achieved.
c. Cautions and Warnings.
(1) A history of a previous allergic reaction to any of the penicillins is a
(2) Anaphylaxis and other serious hypersensitivity reactions are more
frequent following injection of penicillin. These reactions are more likely to occur in
clients with a history of sensitivity to multiple allergens or asthma.
Continue therapy for a minimum of 10 days for streptococcal infections.
(4) Frequent evaluation of electrolyte balance, renal, and hematopoietic
function is recommended during therapy when high doses of intravenous potassium
penicillin G are used.
(5) Prolonged use of antibiotics may promote a superinfection of