Bicillin CR

Introduction

Combination of 1st generation penicillins.

Combination of procaine penicillin & benzathine penicillin

Indications

• for IM use in mixes of 150/150, 300/300, 600/600, 300/900 (procaine/benzathine penicillin)
• active against most gram positive organisms, especially Streptococcus species

Contraindications

pregnancy-category B

safety in lactation ?

Dosage

• children > 60 lbs & adults:
  • 2.4 million units IM (single dose)
• children 30-60 lbs:
  • 1.2 million units IM (single dose)
• children < 30 lbs:
  • 600,000 units IM (single dose)

Pharmacokinetics

elimination: kidney

Adverse effects

• not common (1-10%)
• Jarisch-Herxheimer reaction
• CNS toxicity
  • convulsions
  • confusion
  • drowsiness
  • myoclonus
• positive direct antiglobulin (Coomb's) test (DAT)
• hemolytic anemia
• interstitial nephritis
• hypersensitivity

More general terms

• antibiotic combination

Components

• benzathine penicillin (Bicillin L-A)
• procaine penicillin (Wycillin)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=15232
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=64725
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=656811
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=22502