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Home Drugs A to Z Penicillin g sodium Dosage
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Penicillin G Sodium Dosage

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o
Applies to the following strength(s): 5,000,000 units
The information at Drugs.com is not a substitute for medical

advice. Always consult your doctor or pharmacist.
Usual Adult Dose for:

Pneumonia
Septicemia
Bacterial Infection
Streptococcal Infection
Endocarditis
Meningitis
Meningitis - Pneumococcal
Meningitis - Meningococcal
Neurosyphilis
Actinomycosis
Inhalation Bacillus anthracis
Cutaneous Bacillus anthracis
Clostridial Infection
Tetanus
Botulism
Diphtheria
Fusospirochetosis
Bacteremia
Gram Negative Infection
Rat-bite Fever
Lyme Disease - Arthritis
Lyme Disease - Carditis
Lyme Disease - Neurologic
Prevention of Perinatal Group B Streptococcal
Disease
Skin or Soft Tissue Infection
Joint Infection
Osteomyelitis
Leptospirosis
Gonococcal Infection - Disseminated
Usual Pediatric Dose for:

Bacterial Infection
Pneumonia
Streptococcal Infection
Endocarditis
Meningitis - Meningococcal
Meningitis
Meningitis - Pneumococcal
Meningitis - Streptococcus Group B
Congenital Syphilis
Neurosyphilis
Inhalation Bacillus anthracis
Cutaneous Bacillus anthracis
Diphtheria
Rat-bite Fever
Lyme Disease - Arthritis
Lyme Disease - Carditis
Lyme Disease - Neurologic
Skin or Soft Tissue Infection
Tetanus
Gonococcal Infection - Disseminated
Additional dosage information:

Renal Dose Adjustments
Liver Dose Adjustments
Dose Adjustments
Precautions
Dialysis
Other Comments
Usual Adult Dose for Pneumonia

5 to 24 million units/day IV in equally divided doses every 4 to 6
hours
Comments:
-Dose depends on the nature and severity of the infection.
Uses: For the treatment of serious infections (septicemia,

empyema, pneumonia, pericarditis, endocarditis, meningitis) due
to Streptococcus pyogenes, other beta-hemolytic streptococci
(including groups C, H, G, L, M), S pneumoniae, Staphylococcus
species (non-penicillinase-producing strains)
Usual Adult Dose for Septicemia

hours
Comments:

Usual Adult Dose for Bacterial

Infection
hours
Comments:

Usual Adult Dose for Streptococcal

Infection
hours
Comments:

Usual Adult Dose for Endocarditis

Streptococci or staphylococci infection: 5 to 24 million units/day
IV in equally divided doses every 4 to 6 hours
Erysipelothrix infection: 12 to 20 million units/day IV in divided
doses every 4 to 6 hours for 4 to 6 weeks
Listeria infection: 15 to 20 million units/day IV in divided doses
every 4 to 6 hours for 4 weeks
Comments:
-Dose for streptococcal or staphylococcal infection depends on
the nature and severity of the infection.
Use: For the treatment of endocarditis due to S pyogenes, other

beta-hemolytic streptococci (including groups C, H, G, L, M), S
pneumoniae, Staphylococcus species (non-penicillinase-producing
strains), Erysipelothrix rhusiopathiae, Listeria monocytogenes
American Heart Association (AHA) and Infectious Diseases

Society of America (IDSA) Recommendations:
-Native valve infective endocarditis (NVE) due to highly penicillin-
susceptible viridans group streptococci (VGS) or S gallolyticus
(bovis) (MIC up to 0.12 mcg/mL): 12 to 18 million units/day IV
continuously or in 4 or 6 equally divided doses for 4 weeks
-NVE due to relatively penicillin-resistant strains of VGS or S
gallolyticus (MIC greater than 0.12 mcg/mL to less than 0.5
mcg/mL): 24 million units/day IV continuously or in 4 to 6 equally
divided doses for 4 weeks
-Prosthetic valve (or other prosthetic material) infection due to
VGS or S gallolyticus: 24 million units/day IV continuously or in 4
to 6 equally divided doses for 6 weeks
-NVE or prosthetic valve (or other prosthetic material) infection
due to Enterococcus species (if able to tolerate beta-lactam
therapy): 18 to 30 million units/day IV continuously or in 6 equally
divided doses for 4 to 6 weeks
Comments:
-Recommended for patients with normal renal function
-NVE due to highly penicillin-susceptible VGS or S gallolyticus: 4-
week regimen is preferred in most patients older than 65 years or
patients with impaired 8th cranial nerve function or renal
function; if this drug (same dose, continuously or in 6 equally
divided doses) is used with gentamicin, the duration of therapy
may be reduced to 2 weeks; 2-week regimen not recommended if
known cardiac/extracardiac abscess, CrCl less than 20 mL/min,
impaired 8th cranial nerve function, or Abiotrophia, Granulicatella,
or Gemella species infection
-NVE due to relatively penicillin-resistant strains of VGS or S
gallolyticus: This drug should be used with gentamicin; infectious
diseases consultation recommended.
-Prosthetic valve (or other prosthetic material) infection due to
VGS or S gallolyticus: This drug may be used with or without
gentamicin if penicillin-susceptible strain (MIC up to 0.12 mcg/mL)
but should be used with gentamicin if relatively/fully penicillin-
resistant strain (MIC greater than 0.12 mcg/mL).
due to Enterococcus species by a strain susceptible to penicillin
and gentamicin (if able to tolerate beta-lactam therapy): This
drug should be used with gentamicin; 4-week regimen
recommended for native valve patients with symptoms of illness
less than 3 months; 6-week regimen recommended for native
valve symptoms greater than 3 months and for patients with
prosthetic valve or prosthetic material; recommended for patients
with CrCl greater than 50 mL/min
due to Enterococcus species by a penicillin-susceptible strain that
is resistant to aminoglycosides or streptomycin-
susceptible/gentamicin-resistant (if able to tolerate beta-lactam
therapy): This drug should be used with streptomycin; this
regimen is not recommended if CrCl less than 50 mL/min prior to
or during therapy or cranial nerve VIII function is abnormal.
-Current guidelines should be consulted for additional information.
Usual Adult Dose for Meningitis

Pasteurella infection: 4 to 6 million units/day IV in divided doses
Comments:
Use: For the treatment of meningitis due to S pyogenes, other

strains), L monocytogenes, Pasteurella multocida
IDSA Recommendations: 24 million units/day IV in divided doses

every 4 hours
Duration of therapy:
-L monocytogenes: At least 21 days
-S agalactiae: 14 to 21 days
-S pneumoniae: 10 to 14 days
Comments:
-A recommended agent for infection due to L monocytogenes or S
agalactiae; use with an aminoglycoside should be considered.
-Considered standard therapy for S pneumoniae infection with
penicillin MIC less than 0.1 mcg/mL
Usual Adult Dose for Meningitis -

Pneumococcal
Pasteurella infection: 4 to 6 million units/day IV in divided doses
Comments:
Use: For the treatment of meningitis due to S pyogenes, other

strains), L monocytogenes, Pasteurella multocida

every 4 hours
Comments:
-A recommended agent for infection due to L monocytogenes or S
agalactiae; use with an aminoglycoside should be considered.
-Considered standard therapy for S pneumoniae infection with
Usual Adult Dose for Meningitis -

Meningococcal
24 million units/day, administered as 2 million units IV every 2
hours
Use: For the treatment of meningococcal meningitis and/or

septicemia due to Neisseria meningitidis

every 4 hours for 7 days
Comments:
-Recommended as an alternative agent for infection due to N
meningitidis
-Considered standard therapy for N meningitidis infection with
Usual Adult Dose for Neurosyphilis

12 to 24 million units/day, administered as 2 to 4 million units IV
every 4 hours for 10 to 14 days
Comments:
-Many experts recommend additional therapy with penicillin G
benzathine after completion of IV therapy.
-Adequate follow-up (including clinical and serological
examinations) recommended for all cases of penicillin-treated
syphilis; US CDC guidelines should be consulted.
Use: For the treatment of neurosyphilis due to Treponema

pallidum
US CDC Recommendations: 18 to 24 million units/day,

administered as 3 to 4 million units IV every 4 hours or a
continuous IV infusion for 10 to 14 days
Comments:
-Recommended as the preferred regimen for neurosyphilis and
ocular syphilis
-US CDC, National Institutes of Health (NIH), and HIV Medicine
Association of the IDSA (HIVMA/IDSA) also recommend this as the
preferred regimen for neurosyphilis, ocular syphilis, and otic
syphilis in HIV-infected adults.
-Duration of neurosyphilis therapy is shorter than the duration for
latent syphilis therapy; penicillin G benzathine can be considered
after completing this drug to provide comparable total duration of
therapy.
-The patient's sexual partner(s) should also be evaluated/treated.
Usual Adult Dose for Actinomycosis
Cervicofacial disease: 1 to 6 million units/day IV in divided doses
every 4 to 6 hours
Thoracic and abdominal disease: 10 to 20 million units/day IV in
divided doses every 4 to 6 hours
Uses: For the treatment of actinomycosis (cervicofacial disease,

thoracic and abdominal disease) due to Actinomyces israelii
Usual Adult Dose for Inhalation

Bacillus anthracis
Minimum of 8 million units/day IV in divided doses every 6 hours
Comments:
-Higher doses may be needed depending on susceptibility of
organism.
Use: For the treatment of anthrax due to Bacillus anthracis
US CDC Recommendations: 4 million units IV every 4 hours
Duration of Therapy:
-With possible/confirmed meningitis: At least 2 to 3 weeks or until
patient is clinically stable (whichever is longer)
-When meningitis has been excluded: At least 2 weeks or until
-Patients exposed to aerosolized spores will require prophylaxis to
complete an antimicrobial regimen of 60 days from onset of
illness.
Comments:
-Recommended as an alternative agent for the treatment of
systemic anthrax due to penicillin-susceptible strains (MIC less
than 0.125 mcg/mL)
-Recommended for use with a protein synthesis inhibitor; the
addition of a bactericidal fluoroquinolone is recommended with
possible/confirmed meningitis.
-Systemic anthrax includes anthrax meningitis, inhalation
anthrax, injection anthrax, gastrointestinal anthrax, and
cutaneous anthrax with systemic involvement, extensive edema,
or lesions of the head or neck.
Usual Adult Dose for Cutaneous

Bacillus anthracis
Minimum of 8 million units/day IV in divided doses every 6 hours
Comments:
-Higher doses may be needed depending on susceptibility of
organism.
Use: For the treatment of anthrax due to Bacillus anthracis
US CDC Recommendations: 4 million units IV every 4 hours
Duration of Therapy:
-With possible/confirmed meningitis: At least 2 to 3 weeks or until
-When meningitis has been excluded: At least 2 weeks or until
-Patients exposed to aerosolized spores will require prophylaxis to
complete an antimicrobial regimen of 60 days from onset of
illness.
Comments:
systemic anthrax due to penicillin-susceptible strains (MIC less
than 0.125 mcg/mL)
-Recommended for use with a protein synthesis inhibitor; the
addition of a bactericidal fluoroquinolone is recommended with
possible/confirmed meningitis.
-Systemic anthrax includes anthrax meningitis, inhalation
Usual Adult Dose for Clostridial

Infection
20 million units/day IV in divided doses every 4 to 6 hours
Comments:
-Debridement and/or surgery as indicated for gas gangrene.
Uses: For botulism (as adjunctive therapy to antitoxin), gas

gangrene, tetanus (as adjunctive therapy to human tetanus
immune globulin) due to Clostridium species
Usual Adult Dose for Tetanus

Comments:

Usual Adult Dose for Botulism

Comments:

Usual Adult Dose for Diphtheria

2 to 3 million units/day IV in divided doses every 4 to 6 hours for
10 to 12 days
Uses: For diphtheria (as adjunctive therapy to antitoxin and

prevention of carrier state) due to Corynebacterium diphtheriae
Usual Adult Dose for Fusospirochetosis

5 to 10 million units/day IV in divided doses every 4 to 6 hours
Uses: For the treatment of fusospirochetosis (severe infections of

the oropharynx [Vincent's], lower respiratory tract, genital area)
due to Fusobacterium species and spirochetes
Usual Adult Dose for Bacteremia

Pasteurella infections: 4 to 6 million units/day IV in divided doses
Gram-negative bacillary infections: No specific guidelines have
been suggested by the manufacturer.
Comments:
-Penicillin G is not a drug of choice for treating gram-negative
bacillary infections; previously, some species of gram-negative
bacilli were considered susceptible to very high IV doses (up to 80
million units/day). Other more effective agents are usually used to
treat these infections.
Uses: For the treatment of Pasteurella infections (including

bacteremia, meningitis) due to P multocida; for the treatment of
gram-negative bacillary infections (bacteremias) due to
Escherichia coli, Enterobacter aerogenes, Alcaligenes faecalis,
Salmonella, Shigella, Proteus mirabilis
Usual Adult Dose for Gram Negative

Infection
Pasteurella infections: 4 to 6 million units/day IV in divided doses
Gram-negative bacillary infections: No specific guidelines have
been suggested by the manufacturer.
Comments:
-Penicillin G is not a drug of choice for treating gram-negative
bacillary infections; previously, some species of gram-negative
bacilli were considered susceptible to very high IV doses (up to 80
million units/day). Other more effective agents are usually used to
treat these infections.
Uses: For the treatment of Pasteurella infections (including

bacteremia, meningitis) due to P multocida; for the treatment of
gram-negative bacillary infections (bacteremias) due to
Escherichia coli, Enterobacter aerogenes, Alcaligenes faecalis,
Salmonella, Shigella, Proteus mirabilis
Usual Adult Dose for Rat-bite Fever

12 to 20 million units/day IV in divided doses every 4 to 6 hours
for 3 to 4 weeks
Uses: For the treatment of Haverhill fever due to Streptobacillus

moniliformis; for the treatment of rat-bite fever due to Spirillum
minus or S moniliformis
Usual Adult Dose for Lyme Disease -

Arthritis
American Academy of Neurology (AAN) and IDSA
Recommendations: 18 to 24 million units/day IV in divided doses
every 4 hours
Duration of therapy: 14 days
Comments:
-IDSA recommends this drug as an alternative parenteral regimen
for early neurologic disease (meningitis or radiculopathy), cardiac
disease, and late disease (recurrent arthritis after oral regimen,
central or peripheral nervous system disease).
-Duration of therapy has ranged from 10 to 28 days.

Carditis
every 4 hours
Comments:

Neurologic
every 4 hours
Comments:
Usual Adult Dose for Prevention of
Perinatal Group B Streptococcal
Disease
US CDC Recommendations: 5 million units IV initially followed by
2.5 to 3 million units IV every 4 hours until delivery
Comments:
-A recommended regimen for intrapartum antibiotic prophylaxis
for prevention of early-onset group B streptococcal disease
-Use of this drug for at least 4 hours before delivery is considered
adequate intrapartum antibiotic prophylaxis.
Usual Adult Dose for Skin or Soft

Tissue Infection
IDSA Recommendations: 2 to 4 million units IV every 4 to 6 hours
Comments:
-Recommended for the treatment of non-purulent skin and soft
tissue infection (cellulitis)/streptococcal skin infection
-In combination with clindamycin, recommended as the preferred
regimen for the treatment of necrotizing infections of the skin,
fascia, and muscle due to Streptococcus or Clostridium species
Usual Adult Dose for Joint Infection

IDSA Recommendations:
-Enterococcus species (penicillin-susceptible), streptococci (beta-
hemolytic): 20 to 24 million units/day IV continuously or in 6
divided doses
-Propionibacterium acnes: 20 million units/day IV continuously or
in 6 divided doses
-Native vertebral osteomyelitis: 6 weeks
-Prosthetic joint infection: 4 to 6 weeks
Comments:
-Recommended as a preferred regimen for the treatment of native
vertebral osteomyelitis and prosthetic joint infection due to
penicillin-susceptible Enterococcus species, beta-hemolytic
streptococci, or P acnes
-Penicillin-susceptible Enterococcus species: For patients with
native vertebral osteomyelitis, aminoglycoside should be added
for those with infective endocarditis and is optional for others; for
patients with prosthetic joint infection, aminoglycoside optional
Usual Adult Dose for Osteomyelitis

-Enterococcus species (penicillin-susceptible), streptococci (beta-
hemolytic): 20 to 24 million units/day IV continuously or in 6
divided doses
-Propionibacterium acnes: 20 million units/day IV continuously or
in 6 divided doses
-Native vertebral osteomyelitis: 6 weeks
-Prosthetic joint infection: 4 to 6 weeks
Comments:
-Recommended as a preferred regimen for the treatment of native
vertebral osteomyelitis and prosthetic joint infection due to
penicillin-susceptible Enterococcus species, beta-hemolytic
streptococci, or P acnes
-Penicillin-susceptible Enterococcus species: For patients with
native vertebral osteomyelitis, aminoglycoside should be added
for those with infective endocarditis and is optional for others; for
patients with prosthetic joint infection, aminoglycoside optional
Usual Adult Dose for Leptospirosis

Some experts recommend: 1.5 million units IV every 6 hours for 7
days
Usual Adult Dose for Gonococcal

Infection - Disseminated
Duration of therapy: Depends on nature and severity of infection
Comments:
-Due to resistance, penicillins are not recommended by the US
CDC.
Use: For the treatment of disseminated gonococcal infections

(such as meningitis, endocarditis, arthritis, etc.) due to penicillin-
susceptible N gonorrhoeae
Usual Pediatric Dose for Bacterial

Infection
American Academy of Pediatrics (AAP) Recommendations:
7 days or younger: 25,000 to 50,000 units/kg IM or IV every 12
hours
8 to 28 days: 25,000 to 50,000 units/kg IM or IV every 8 hours
1 month or older:
Mild to moderate infections: 100,000 to 150,000 units/kg/day IM
or IV in 4 divided doses
Maximum dose: 8 million units/day
Severe infections: 200,000 to 300,000 units/kg/day IM or IV in 4 to

6 divided doses
Usual Pediatric Dose for Pneumonia

150,000 units/kg/day IV in equally divided doses every 4 to 6
hours
Uses: For the treatment of serious infections (such as pneumonia,

endocarditis) due to susceptible strains of streptococci (including
S pneumoniae) and meningococcus
AAP Recommendations:
-Invasive pneumococcal infections in patients 1 month or older:
250,000 to 400,000 units/kg/day IV in divided doses every 4 to 6
hours
PIDS and IDSA Recommendations:

Community-acquired pneumonia in infants and children
older than 3 months:
-S pneumoniae with penicillin MIC up to 2 mcg/mL: 200,000 to
250,000 units/kg/day IV in divided doses every 4 to 6 hours
-Group A Streptococcus: 100,000 to 250,000 units/kg/day IV in
Comments:
-PIDS/IDSA: Recommended as preferred parenteral therapy
Usual Pediatric Dose for Streptococcal

Infection
hours
Uses: For the treatment of serious infections (such as pneumonia,

endocarditis) due to susceptible strains of streptococci (including
S pneumoniae) and meningococcus
hours
PIDS and IDSA Recommendations:

Community-acquired pneumonia in infants and children
older than 3 months:
-S pneumoniae with penicillin MIC up to 2 mcg/mL: 200,000 to
250,000 units/kg/day IV in divided doses every 4 to 6 hours
-Group A Streptococcus: 100,000 to 250,000 units/kg/day IV in
Comments:
-PIDS/IDSA: Recommended as preferred parenteral therapy
Usual Pediatric Dose for Endocarditis

hours
Use: For the treatment of endocarditis due to susceptible strains

of streptococci (including S pneumoniae) and meningococcus
AHA Recommendations:
1 year or older: 200,000 to 300,000 units/kg/day IV in divided
doses every 4 hours
Maximum dose: 12 to 24 million units/day
Duration of therapy: At least 4 to 6 weeks
Comments:
-Recommended regimen for highly penicillin G-susceptible
streptococci (minimum bactericidal concentration [MBC] up to 0.1
mcg/mL), relatively penicillin-resistant streptococci (MBC at least
0.2 mcg/mL), and staphylococci (S aureus or coagulase-negative
staphylococci) susceptible to up to 1 mcg/mL penicillin G (rare)
-Streptococci highly susceptible to penicillin G include most
viridans streptococci, groups A, B, C, G, nonenterococcal group D
streptococci (S bovis, S equinus).
-Streptococci relatively resistant to penicillin include enterococci
and less susceptible viridans streptococci; this drug should be
used with gentamicin for at least the first 2 weeks.
-Pediatric dose should not exceed adult dose.
Usual Pediatric Dose for Meningitis -

Meningococcal
250,000 units/kg/day IV in equally divided doses every 4 hours
Duration of therapy: 7 to 14 days, depending on nature and
severity of infection
AAP Recommendations: 300,000 units/kg/day IV in divided doses

every 4 to 6 hours
-Neonates, age 0 to 7 days: 150,000 units/kg/day IV in divided
doses every 8 to 12 hours
-Infants and children: 300,000 units/kg/day IV in divided doses
every 4 to 6 hours
Comments:
-IDSA: Recommended as an alternative agent for infection due to
N meningitidis; considered standard therapy for N meningitidis
infection with penicillin MIC less than 0.1 mcg/mL; smaller doses
and longer intervals may be appropriate for very low birthweight
neonates (less than 2 kg).
Usual Pediatric Dose for Meningitis

Use: For the treatment of meningitis due to susceptible strains of

pneumococcus
hours
every 4 to 6 hours
Comments:
-IDSA: A recommended agent for infection due to L
monocytogenes or S agalactiae; considered standard therapy for
S pneumoniae infection with penicillin MIC less than 0.1 mcg/mL;
smaller doses and longer intervals may be appropriate for very
low birthweight neonates (less than 2 kg).

Pneumococcal
Use: For the treatment of meningitis due to susceptible strains of

pneumococcus
hours
every 4 to 6 hours
Comments:
-IDSA: A recommended agent for infection due to L
monocytogenes or S agalactiae; considered standard therapy for
S pneumoniae infection with penicillin MIC less than 0.1 mcg/mL;
smaller doses and longer intervals may be appropriate for very
low birthweight neonates (less than 2 kg).

Streptococcus Group B
-Infants 7 days or younger: 250,000 to 450,000 units/kg/day IV in
3 divided doses
-Infants older than 7 days: 450,000 to 500,000 units/kg/day IV in
4 divided doses
Duration of therapy (uncomplicated meningitis): 14 days
Comments:
-Longer duration of therapy may be needed for patients with
prolonged or complicated infections.
Usual Pediatric Dose for Congenital

Syphilis
1 month or older: 200,000 to 300,000 units/kg/day, administered
as 50,000 units/kg IV every 4 to 6 hours for 10 to 14 days
Use: For the treatment of congenital syphilis due to T pallidum
US CDC and AAP Recommendations:

Neonates: 100,000 to 150,000 units/kg/day, administered as
50,000 units/kg IV every 12 hours during the first 7 days of life
and every 8 hours thereafter for 10 days total
as 50,000 units/kg IV every 4 to 6 hours for 10 days
Comments:
-Recommended as a preferred regimen for neonates with proven,
highly probable, or possible congenital syphilis, for infants and
children (1 month or older) who possibly have congenital syphilis
or who have neurologic involvement, for children older than 2
years with late and previously untreated congenital syphilis
-US CDC, NIH, HIVMA/IDSA, Pediatric Infectious Diseases Society
(PIDS), and AAP also recommend this regimen for HIV-exposed
and HIV-infected children.
-In neonates, dose should be based on chronologic age.
-If more than 1 day of therapy is missed in neonates with proven
or highly probable disease, the entire course should be repeated.
-Some experts recommend following this regimen with penicillin G
benzathine.
Usual Pediatric Dose for Neurosyphilis
as 50,000 units/kg IV every 4 to 6 hours for 10 to 14 days
Use: For the treatment of neurosyphilis due to T pallidum
AAP Recommendations for Patients Older than 1 Month and US

CDC, NIH, HIVMA/IDSA, PIDS, and AAP Recommendations for HIV-
exposed and HIV-infected Children: 200,000 to 300,000
units/kg/day, administered as 50,000 units/kg IV every 4 to 6
hours for 10 to 14 days
US CDC, NIH, and HIVMA/IDSA Recommendations for HIV-infected

Adolescents: 18 to 24 million units/day, administered as 3 to 4
million units IV every 4 hours or a continuous IV infusion for 10 to
14 days
Comments:
-Recommended as the preferred regimen for neurosyphilis in
patients older than 1 month, for neurosyphilis (including ocular) in
HIV-exposed and HIV-infected children, and for neurosyphilis,
ocular syphilis, and otic syphilis in HIV-infected adolescents
-Duration of neurosyphilis therapy is shorter than the duration for
latent syphilis therapy; penicillin G benzathine can be considered
after completing this drug to provide comparable total duration of
therapy.
-The patient's sexual partner(s) should also be evaluated/treated.
Usual Pediatric Dose for Inhalation

Bacillus anthracis
Up to 4 weeks of age:
-Gestational age 32 to 34 weeks, up to 1 week of age: 200,000
units/kg/day IV in divided doses every 12 hours
-Gestational age 32 to 34 weeks, 1 to 4 weeks of age: 300,000
-Gestational age 34 to 37 weeks and term neonate, up to 1 week
of age: 300,000 units/kg/day IV in divided doses every 8 hours
-Gestational age 34 to 37 weeks and term neonate, 1 to 4 weeks
1 month or older: 400,000 units/kg/day IV in divided doses every

4 hours
Maximum dose: 4 million units/dose
-Severe anthrax (up to 4 weeks of age): At least 2 to 3 weeks or
until patient is clinically stable (whichever is longer)
-Systemic anthrax with possible/confirmed meningitis (1 month or
older): At least 2 to 3 weeks or until patient is clinically stable
(whichever is longer)
-Systemic anthrax when meningitis has been excluded (1 month
or older): At least 14 days or until patient is clinically stable
-Patients will require prophylaxis to complete an antimicrobial
regimen of up to 60 days from onset of illness.
Comments:
systemic/severe anthrax due to penicillin-susceptible strains
-Recommended for use with a protein synthesis inhibitor when
used for systemic anthrax; the addition of a bactericidal
fluoroquinolone is recommended with possible/confirmed
meningitis.
-Systemic/severe anthrax includes anthrax meningitis, inhalation
Usual Pediatric Dose for Cutaneous

Bacillus anthracis
Up to 4 weeks of age:
-Gestational age 32 to 34 weeks, up to 1 week of age: 200,000
-Gestational age 32 to 34 weeks, 1 to 4 weeks of age: 300,000
-Gestational age 34 to 37 weeks and term neonate, up to 1 week
-Gestational age 34 to 37 weeks and term neonate, 1 to 4 weeks
1 month or older: 400,000 units/kg/day IV in divided doses every

4 hours
Maximum dose: 4 million units/dose
-Severe anthrax (up to 4 weeks of age): At least 2 to 3 weeks or
until patient is clinically stable (whichever is longer)
-Systemic anthrax with possible/confirmed meningitis (1 month or
older): At least 2 to 3 weeks or until patient is clinically stable
-Systemic anthrax when meningitis has been excluded (1 month
or older): At least 14 days or until patient is clinically stable
-Patients will require prophylaxis to complete an antimicrobial
regimen of up to 60 days from onset of illness.
Comments:
systemic/severe anthrax due to penicillin-susceptible strains
-Recommended for use with a protein synthesis inhibitor when
used for systemic anthrax; the addition of a bactericidal
fluoroquinolone is recommended with possible/confirmed
meningitis.
-Systemic/severe anthrax includes anthrax meningitis, inhalation
Usual Pediatric Dose for Diphtheria
150,000 to 250,000 units/kg/day IV in equally divided doses every
6 hours for 7 to 10 days
Comments:
-AAP recommendations: As IV antimicrobial therapy for 14 days;
not a substitute for primary therapy (antitoxin); current guidelines
should be consulted for additional information.
Uses: For diphtheria (as adjunctive therapy to antitoxin and

prevention of carrier state) due to C diphtheriae
Usual Pediatric Dose for Rat-bite Fever

150,000 to 250,000 units/kg/day IV in equally divided doses every
4 hours for 4 weeks
Comments:
-AAP recommendations: As IV therapy for 5 days to at least 4
weeks; current guidelines should be consulted for additional
information.
Uses: For the treatment of Haverhill fever with endocarditis due to

S moniliformis; for the treatment of rat-bite fever due to S minus
or S moniliformis
Usual Pediatric Dose for Lyme Disease

- Arthritis
AAN, AAP, and IDSA Recommendations:
Children: 200,000 to 400,000 units/kg/day IV in divided doses
every 4 hours
Comments:
-AAP recommends this drug as an alternative parenteral regimen
for recurrent arthritis, carditis, meningitis, and encephalitis/other
late neurologic disease (including peripheral neuropathy,
encephalopathy).

- Carditis
every 4 hours
Comments:
encephalopathy).

- Neurologic
every 4 hours
Comments:
encephalopathy).
Usual Pediatric Dose for Skin or Soft

Tissue Infection
1 month or older: 60,000 to 100,000 units/kg IV every 6 hours
Maximum dose: 2 to 4 million units/dose
Comments:
-Recommended for the treatment of non-purulent skin and soft
tissue infection (cellulitis)/streptococcal skin infection
-In combination with clindamycin, recommended as the preferred
regimen for the treatment of necrotizing infections of the skin,
fascia, and muscle due to Streptococcus or Clostridium species
Usual Pediatric Dose for Tetanus

AAP Recommendations: 100,000 units/kg/day IV in divided doses
every 4 to 6 hours
Duration of therapy: 7 to 10 days
Comments:
-Recommended as alternative therapy
Usual Pediatric Dose for Gonococcal

Infection - Disseminated
Less than 45 kg:
-Arthritis: 100,000 units/kg/day in 4 equally divided doses for 7 to
10 days
-Meningitis: 250,000 units/kg/day in equally divided doses every 4
hours for 10 to 14 days
-Endocarditis: 250,000 units/kg/day in equally divided doses every
4 hours for 4 weeks
At least 45 kg:
-Arthritis, meningitis, endocarditis: 10 million units/day in 4
equally divided doses
-Duration of therapy: Depends on the type of infection
Comments:
-Due to resistance, penicillins are not recommended by the US
CDC.
Use: For the treatment of disseminated gonococcal infections

(arthritis, meningitis, endocarditis) due to penicillin-susceptible N
gonorrhoeae
Renal Dose Adjustments

Uremic patients with CrCl greater than 10 mL/min/1.73 m2:
Administer a full loading dose followed by one-half of the loading
dose every 4 to 5 hours.
CrCl less than 10 mL/min/1.73 m2: Administer a full loading dose
followed by one-half of the loading dose every 8 to 10 hours.
Comments:
-Additional dose reductions are recommended in patients with
liver disease and renal dysfunction.
-Because incompletely developed renal function in neonates may
delay elimination of penicillin, appropriate reductions in dose and
frequency of administration are recommended.
-Some clinicians recommend a maximum dose of 4 to 10 million
units/day in patients with severe renal failure.
Liver Dose Adjustments

Liver dysfunction: No adjustment recommended.
Comments:
-Dose reductions are recommended in patients with liver disease
and renal dysfunction.
Dose Adjustments
A reduction in total dose should be considered if any impairment
of organ system function (including electrolyte balance, hepatic,
renal, and hematopoietic systems, and cardiac and vascular
status) occurs or is suspected.
Precautions
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Comments:
-Hemodialysis has been shown to reduce penicillin G serum levels.
-Some clinicians recommend a maximum dose of 4 million to 10
million units/day in patients with severe renal failure.
Other Comments
Administration advice:
-May administer IV or IM
-In general, administer IV when large doses (10 million units or
greater) are needed.
-Administer large IV doses (more than 10 million units) slowly as
electrolyte imbalances may occur due to the sodium content of
this drug
-Due to its short half-life, administer penicillin G in divided doses,
usually every 4 to 6 hours; however, administer every 2 hours
when used for meningococcal meningitis/septicemia.
-For most acute infections, continue treatment for at least 48 to
72 hours after patient becomes asymptomatic; for group A beta-
hemolytic streptococcal infections, continue treatment for at least
10 days to reduce the risk of rheumatic fever.
Storage requirements:
-Dry powder: Store at 20C to 25C (68F to 77F).
-Sterile constituted solution: May store in refrigerator (2C to 8C)
for 3 days
Reconstitution/preparation techniques:
-The manufacturer product information should be consulted.
-Penicillins rapidly inactivated with carbohydrate solutions at
alkaline pH.
IV compatibility:
-Compatible: Sterile Water for Injection; 0.9% Sodium Chloride
Injection, USP; Dextrose Injections, USP
General:
-This drug is for the treatment of serious infections due to
susceptible strains of the designated bacteria.
-In suspected staphylococcal infections, proper laboratory studies
(including susceptibility tests) are recommended.
-To reduce the development of drug-resistant organisms and
maintain effective therapy, this drug should be used only to treat
or prevent infections proven or strongly suspected to be caused
by susceptible bacteria.
-Culture and susceptibility information should be considered when
selecting/modifying antibacterial therapy or, if no data are
available, local epidemiology and susceptibility patterns may be
considered when selecting empiric therapy.
-Appropriate culture and susceptibility testing recommended
before therapy to isolate and identify infecting organisms and to
establish susceptibility to this drug. Therapy may be started
before test results are known; appropriate therapy should be
continued when results are available.
Monitoring:
-Cardiovascular: Cardiac and vascular status (periodically during
prolonged therapy with high doses of IV penicillin G)
-General: For clinical and laboratory signs of toxicity in all
neonates; organ system function (periodically during prolonged
therapy with high doses of IV penicillin G)
-Hematologic: Hematopoietic system function (periodically during
prolonged therapy with high doses of IV penicillin G)
-Hepatic: Hepatic system function (periodically during prolonged
-Metabolic: Electrolyte balance (frequently during prolonged
-Renal: Renal system function (periodically during prolonged
Patient advice:
-Avoid missing doses and complete the entire course of therapy.
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DRUG STATUS
AvailabilityRxPrescription only
Pregnancy CategoryBNo proven risk in humans
CSA ScheduleNNot a controlled drug
Approval HistoryCalendarDrug history at FDA

Drug Class
Natural penicillins
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Browse all medications: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Penicillin G Sodium Dosage

Applies to the following strength(s): 5,000,000 units

The information at Drugs.com is not a substitute for medical

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Pneumonia

Uses: For the treatment of serious infections (septicemia,

Usual Adult Dose for Septicemia

Uses: For the treatment of serious infections (septicemia,

Usual Adult Dose for Bacterial

Uses: For the treatment of serious infections (septicemia,

Usual Adult Dose for Streptococcal

Uses: For the treatment of serious infections (septicemia,

Usual Adult Dose for Endocarditis

Use: For the treatment of endocarditis due to S pyogenes, other

American Heart Association (AHA) and Infectious Diseases

Usual Adult Dose for Meningitis

Use: For the treatment of meningitis due to S pyogenes, other

IDSA Recommendations: 24 million units/day IV in divided doses

Usual Adult Dose for Meningitis -

Use: For the treatment of meningitis due to S pyogenes, other

IDSA Recommendations: 24 million units/day IV in divided doses

Usual Adult Dose for Meningitis -

Use: For the treatment of meningococcal meningitis and/or

IDSA Recommendations: 24 million units/day IV in divided doses

Usual Adult Dose for Neurosyphilis

Use: For the treatment of neurosyphilis due to Treponema

US CDC Recommendations: 18 to 24 million units/day,

Uses: For the treatment of actinomycosis (cervicofacial disease,

Usual Adult Dose for Inhalation

Use: For the treatment of anthrax due to Bacillus anthracis

US CDC Recommendations: 4 million units IV every 4 hours

Usual Adult Dose for Cutaneous

Use: For the treatment of anthrax due to Bacillus anthracis

US CDC Recommendations: 4 million units IV every 4 hours

Usual Adult Dose for Clostridial

Uses: For botulism (as adjunctive therapy to antitoxin), gas

Usual Adult Dose for Tetanus

Uses: For botulism (as adjunctive therapy to antitoxin), gas

Usual Adult Dose for Botulism

Uses: For botulism (as adjunctive therapy to antitoxin), gas

Usual Adult Dose for Diphtheria

Uses: For diphtheria (as adjunctive therapy to antitoxin and

Usual Adult Dose for Fusospirochetosis

Uses: For the treatment of fusospirochetosis (severe infections of

Usual Adult Dose for Bacteremia

Uses: For the treatment of Pasteurella infections (including

Usual Adult Dose for Gram Negative

Uses: For the treatment of Pasteurella infections (including

Usual Adult Dose for Rat-bite Fever

Uses: For the treatment of Haverhill fever due to Streptobacillus

Usual Adult Dose for Lyme Disease -

Usual Adult Dose for Lyme Disease -

Usual Adult Dose for Lyme Disease -

Usual Adult Dose for Skin or Soft

Usual Adult Dose for Joint Infection

Usual Adult Dose for Osteomyelitis

Usual Adult Dose for Leptospirosis

Usual Adult Dose for Gonococcal

Use: For the treatment of disseminated gonococcal infections

Usual Pediatric Dose for Bacterial