Benzylpenicillin (Neonatal Formulary)

Audience

HHSCP only
SCBU only

Benzylpenicillin - For use up to 28 days of age

Indication

Bacterial infection: pneumococcal, meningococcal, streptococcal, gonococcal.

DRUG	DOSE	DOSES/DAY	ROUTE
benzylpenicillin (Crystapen)	50mg/kg For doses > 50mg/kg, see preparation notes below.	One dose every 12 hours in babies up to 6 days old. One dose every 8 hours in babies 7 to 28 days old. The dose should be reduced in renal failure.	Slow IV bolus over 5 minutes. Some infants have developed severe local reactions to IM injections, so IV treatment is preferable.

DRUG

DOSE

DOSES/DAY

ROUTE

benzylpenicillin (Crystapen)

50mg/kg

For doses > 50mg/kg, see preparation notes below.

One dose every 12 hours in babies up to 6 days old.

One dose every 8 hours in babies 7 to 28 days old.

The dose should be reduced in renal failure.

Slow IV bolus over 5 minutes.

Some infants have developed severe local reactions to IM injections, so IV treatment is preferable.

Supply

Each ampoule contains 600mg of benzylpenicillin.

Preparation

Add 4·6mL of sterile water to each 600mg vial, as there is a displacement value of 0·4mL. This gives a solution containing 120mg/mL (600mg/5mL) benzylpenicillin.

For doses greater than 50mg/kg, further dilute to a concentration of 60mg/mL with 5mL sodium chloride 0.9% or glucose 5% and give over 15 minutes.

Solution compatibility	glucose 5%, glucose 10%, sodium chloride 0·45%, sodium chloride 0·9%, buffered sodium chloride 0·9%
IV line compatibility	calcium chloride, calcium gluconate, chloramphenicol, clarithromycin, erythromycin, gentamicin, hydrocortisone sodium succinate, pantoprazole, ranitidine
IV line incompatibility	amphoteracin, cimetidine, cytarabine, dobutamine, flucloxacillin, insulin, intralipid, methylprednisolone, phenytoin, potassium chloride, promethazine, sodium bicarbonate and vancomycin