페니실린 G
Penicillin G
Benzylpenicillin
다른 이름: Bicillin C-R · Masti-Clear · Permapen · Pfizerpen · Go-Dry · crystalline penicillin G · APPG · aqueous penicillin · procaine benzylpenicillin
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Susceptible infections (extra-label): Penicillin G procaine
인증된 수의사 확인 필요
- q12-24h
NA
반드시 함께 고려할 임상 맥락 (4)
- NOTE: Label dosages of penicillin have been unchanged for decades and may result in marked underdosing based on current understanding of antibiotic therapy. Although consideration of the label recommendations is required, present-day recommended dosing regimens should be used.
- ■ Because penicillins usually have minimal toxicity associated with their use, monitoring for efficacy is usually all that is required unless toxic signs develop. Serum concentrations and therapeutic drug monitoring are not routinely done with these agents.
- Penicillin G procaine should be stored at 2°C to 8°C (36°F-46°F); avoid freezing. Penicillin G benzathine should be stored at 2°C to 8°C (36°F-46°F).
- Penicillin G sodium and potassium powder for injection can be stored at room temperature (15°C-30°C [59°F-86°F]). After reconstituting, the injectable solution is stable for 7 days when kept refrigerated (2°C-8°C [36°F-46°F]) and for 24 hours at room temperature.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
페니실린 G(벤질페니실린)는 Penicillium chrysogenum에서 추출한 좁은 스펙트럼의 천연 베타락탐계 항생제입니다. 대부분의 그람 양성 호기성 세균(예: 연쇄상구균, 페니실리나아제 비생성 포도상구균), 일부 그람 음성균(예: 파스퇴렐라), 그리고 많은 혐기성 세균(예: 클로스트리듐)에 매우 효과적입니다.
임상 요점: 페니실린 G의 염 형태에 따라 투여 경로와 약동학적 특성이 결정됩니다:
- 수용성 염(나트륨 또는 칼륨): 정맥(IV) 또는 근육(IM) 주사용으로 제조됩니다. 빠르고 높은 최고 혈청 농도를 제공하지만 반감기가 매우 짧아 자주 투여해야 합니다(예: 4-6시간 간격).
- 저장성 염(프로카인 및 벤자틴): 현탁액으로 제조되며 근육(IM) 또는 피하(SC) 주사로만 사용해야 합니다(정맥 주사 절대 금지). 프로카인은 12-24시간 지속되는 데포(depot) 효과를 제공하며, 벤자틴은 수일 동안 지속되는 매우 낮고 연장된 농도를 제공합니다.
페니실린 G는 많은 포도상구균과 그람 음성 장내 세균이 생성하는 베타락타마아제(페니실리나아제) 효소에 의해 분해되기 쉽습니다.
작용 기전
Penicillin G is a time-dependent bactericidal antibiotic.
- It covalently binds to Penicillin-Binding Proteins (PBPs) located on the inner membrane of the bacterial cell wall.
- This binding → inhibits the transpeptidation enzyme responsible for cross-linking peptidoglycan strands.
- Failure of cell wall synthesis → activation of autolytic enzymes within the cell wall → osmotic lysis and bacterial death.
Because it targets cell wall synthesis, it is most effective against actively dividing bacteria.
안전성·주의사항
금기사항
- Known hypersensitivity to penicillins or cephalosporins
- Intravenous administration of Procaine or Benzathine suspension formulations
- Oral administration in horses and hindgut fermenters (rabbits, guinea pigs) due to risk of fatal dysbiosis (unless specifically indicated, e.g., calves with clostridial enteritis)
부작용
- Hypersensitivity reactions (anaphylaxis, urticaria, rash)
- Gastrointestinal upset (anorexia, vomiting, diarrhea) with oral use
- Procaine toxicity (CNS excitement, seizures) in small birds and horses if inadvertently given IV
- Pain or tissue reaction at IM injection sites
주의
Use cautiously in small birds as procaine penicillin may cause procaine toxicity. Do not use oral penicillin therapy in horses for systemic infections (e.g., botulism). Ensure repository forms (procaine/benzathine) are never administered intravenously. Monitor for hypersensitivity reactions. High doses of Penicillin G Potassium given rapidly IV can cause hyperkalemia and cardiac arrhythmias.
약물 상호작용
May antagonize the bactericidal activity of penicillins, which require actively dividing cells to be effective.
In vivo synergy against certain bacteria; however, physically incompatible if mixed in the same syringe or IV line (inactivation of the aminoglycoside).
Competitively inhibits renal tubular secretion of penicillins, significantly prolonging their half-life and increasing serum concentrations.
모니터링
- Clinical efficacy (resolution of infection signs)
- Signs of toxicity or hypersensitivity (anaphylaxis, rash)
- Electrolytes (if using high doses of Na or K salts IV)
약동학
반감기
흡수
Oral absorption is generally poor and variable due to degradation by gastric acid. Aqueous salts (Na/K) are rapidly absorbed after IM/SC injection. Procaine and benzathine salts are slowly absorbed from IM injection sites, providing prolonged but lower serum concentrations.
분포
Widely distributed to most tissues (lungs, kidneys, muscle, bone). Poor penetration into the central nervous system (CNS), eye, and prostate unless severe inflammation is present. Crosses the placenta.
대사
Minimal hepatic metabolism.
배설
Rapidly excreted primarily unchanged in the urine via active renal tubular secretion and glomerular filtration.
과다투여
Because penicillins usually have minimal toxicity associated with their use, monitoring for efficacy is usually all that is required unless toxic signs develop.
Clinical Pearl: Massive overdoses, particularly of aqueous salts given rapidly IV, can lead to neuromuscular hypersensitivity, seizures, or electrolyte imbalances (hyperkalemia with potassium salt, hypernatremia with sodium salt). Treatment is supportive.
제품
제형
- Powder for injection (Potassium or Sodium salts)
- Suspension for injection (Procaine or Benzathine salts)
- Oral tablets and powder for solution
- Intramammary infusion syringes
동물용의약품
- Penicillin G Procaine Injection 300,000 Units/mL
- Penicillin G Procaine Mastitis Syringes 100,000 Units/mL (Go-Dry, Masti-Clear)
- Penicillin G Benzathine 150,000 Units/mL with Penicillin G Procaine 150,000 Units/mL Injection
인용의약품
- Penicillin G (Aqueous) Sodium Powder for Injection: 5,000,000 Units & 20,000,000 Units
- Penicillin G (Aqueous) Potassium Injection: 1,000,000 Units, 2,000,000 Units & 3,000,000 Units
- Penicillin G Procaine Injection: 600,000 Units/vial & 1,200,000 Units/vial
- Penicillin G Benzathine Injection: 600,000, 1,200,000, & 2,400,000 Units/dose
- Penicillin G Benzathine/Penicillin G Procaine IM Injection (Bicillin C-R)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Penicillin G sodium and potassium powders should be protected from moisture. Oral powder for solution: store at room temperature before mixing; after reconstituting, refrigerate (2-8°C) and discard after 14 days. Injectable Na/K solutions: stable for 7 days refrigerated (2-8°C) and 24 hours at room temperature. Procaine and Benzathine suspensions should be stored at 2-8°C; avoid freezing.
보호자 정보
- 투여 방법: 경구용 페니실린은 흡수를 최대화하기 위해 공복(식사 1시간 전 또는 2시간 후)에 투여해야 합니다. 반려동물이 위장 장애(구토, 식욕 부진)를 겪는 경우 소량의 음식과 함께 먹일 수 있습니다.
- 복약 순응도: 반려동물이 완전히 나아진 것 같더라도 처방된 약을 끝까지 모두 먹이는 것이 매우 중요합니다. 일찍 중단하면 내성균 감염이 발생할 수 있습니다.
- 알레르기 반응: 얼굴 부기, 두드러기, 발진 또는 호흡 곤란과 같은 알레르기 반응의 징후가 있는지 관찰하십시오. 이러한 증상이 나타나면 즉시 수의사에게 연락하십시오.
- 주사 부위: 반려동물이 주사제를 맞는 경우 주사 부위가 아프거나 부어오를 수 있습니다.
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