Generic/

Trade Name
Generic
name:
Penicillin G
benzathine
Brand name:
Bicillin,
Permapen

Dosage/
Frequency
Moderate to
severe
infections
Adult and
child: IM 600,0
00-1.2 million
units in 1 or 2
doses/day for
10 days to 2 wk
Newborn:
50,000
units/kg IM onc
e daily (avoid
use in
newborns)
Gonorrhea
Adult and child
>12 yr: IM 4.8
million units in
two injections
given 30 min
after probenecid
1g
Pneumococcal
pneumonia

Classification

Indication

Contraindication

Side-effects

Nsg. Responsibilities

Antibiotic
Penicillin
Antibiotic

Severe
infection
caused by
sensitive
organisms
(streptococci

Contraindicated
with allergies to
penicillins,
cephalosporins or
other allergies.

Nausea, Vomiting,
diarrhea, mouth sores,
pain at injection sites

Assess patient for previous

sensitivity reaction to
penicillins or cephalosporins;
cross-sensitivity between
penicillins and cephalosporins
is common

Use cautiously
URI caused by with renal
sensitive
disorders,
streptococci
pregnancy,
lactation, ( may
Treatment of
cause diarrhea or
syphilis, bejel, candidiasis in the
congenital
infant)
syphilis, pinta,
yaws
Prophylaxis of
rheumatic
fever and
chorea

Assess patient for signs and

symptoms of infection
including characteristics of
wounds, sputum, urine, stool,
WBC >10,000/mm3, earache,
fever; obtain baseline
information and information
during treatment
Obtain C&S before beginning
drug therapy to identify if
correct treatment has been
initiated
Assess for allergic reactions:
rash, urticaria, pruritis, chills,
fever, joint pain; angioedema
may occur a few days after
therapy begins; epinephrine,
resuscitation equipment should
be available for anaphylactic
reaction
Identify urine output; if

Adult/child >12
yr: IM 600,0001.2 million
units/day 7-10
days
Renal dose
CCr 10-30
ml/min giveq812h; CCr< 10
ml/min give
q12-18h
Available
Forms: Inj
300,000,
500,000,
600,000,
1,200,000,
2,400,000
units/dose

decreasing, notify prescriber

(may indicate nephrotoxicity);
also check for increased BUN,
creatinine
Monitor blood studies: CBC,
Hct, bilirubin, LDH, alkaline
phosphatase, AST, ALT,
Coombs' test monthly if patient
is on long-term therapy
Monitor electrolytes:
potassium, sodium, chloride
monthly if patient is on longterm therapy
Assess bowel pattern daily; if
severe diarrhea occurs, drug
should be discontinued; may
indicate pseudomembranous
colitis
Monitor for bleeding:
ecchymosis, bleeding gums,
hematuria, stool guaiac daily if
on long-term therapy
Assess for overgrowth of
infection: perineal itching,
fever, malaise, redness, pain,
swelling, drainage, rash,
diarrhea, change in cough,

sputum
Nursing diagnoses
Infection, risk for (uses)
Diarrhea (adverse reactions)
Injury, risk for (adverse
reactions)
Knowledge, deficient
(teaching)
Noncompliance (teaching)
Implementation
Do not give IV
Give deeply in large muscle
mass
Reconstitute with 0.9% NaCl,
sterile water for inj, D5W;
refrigerate unused portion
Shake medication before
administering
IM route may include procaine
reactions: fear of death,

depression, seizures, anxiety,

confusion, hallucinations
Patient/family education
Teach patient to report sore
throat, bruising, bleeding, joint
pain; may indicate blood
dyscrasias (rare)
Advise patient to contact
prescriber if vaginal itching,
loose, foul-smelling stools,
furry tongue occur; may
indicate superinfection
Instruct patient to take all
medication prescribed for the
length of time ordered
Advise patient to notify
prescriber of diarrhea with
blood or pus, which may
indicate pseudomembranous
colitis
Positive therapeutic outcome
Absence of signs/symptoms of
infection (WBC<10,000/mm3,
temp WNL, absence of red,

draining wounds, earache)

Reported improvement in
symptoms of infection