Penicillin G

Background

Group	Organism	Sensitivity
Gram Positive	Strep. Group A, B, C, G	S
	Strep. Pneumoniae	S
	Viridans strep	I
	Strep. anginosus gp	S
	Enterococcus faecalis	S
	Enterococcus faecium	I
	MSSA	R
	MRSA	R
	CA-MRSA	R
	Staph. Epidermidis	R
	C. jeikeium	R
	L. monocytogenes	S
Gram Negatives	N. gonorrhoeae	R
	N. meningitidis	S
	Moraxella catarrhalis	R
	H. influenzae	R
	E. coli	R
	Klebsiella sp	R
	E. coli/Klebsiella ESBL+	R
	E coli/Klebsiella KPC+	R
	Enterobacter sp, AmpC neg	R
	Enterobacter sp, AmpC pos	R
	Serratia sp	R
	Serratia marcescens	X1
	Salmonella sp	R
	Shigella sp	R
	Proteus mirabilis	R
	Proteus vulgaris	R
	Providencia sp.	R
	Morganella sp.	R
	Citrobacter freundii	R
	Citrobacter diversus	R
	Citrobacter sp.	R
	Aeromonas sp	R
	Acinetobacter sp.	R
	Pseudomonas aeruginosa	R
	Burkholderia cepacia	R
	Stenotrophomonas maltophilia	R
	Yersinia enterocolitica	R
	Francisella tularensis	X1
	Brucella sp.	X1
	Legionella sp.	R
	Pasteurella multocida	S
	Haemophilus ducreyi	S
	Vibrio vulnificus	X1
Misc	Chlamydophila sp	R
	Mycoplasm pneumoniae	R
	Rickettsia sp	X1
	Mycobacterium avium	X1
Anaerobes	Actinomyces	S
	Bacteroides fragilis	R
	Prevotella melaninogenica	S
	Clostridium difficile	X2
	Clostridium (not difficile)	S
	Fusobacterium necrophorum	I
	Peptostreptococcus sp.	S

S susceptible/sensitive (usually)
I intermediate (variably susceptible/resistant)
R resistant (or not effective clinically)
S+ synergistic with cell wall antibiotics
U sensitive for UTI only (non systemic infection)
X1 no data
X2 active in vitro, but not used clinically
X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
X4 active in vitro, but not clinically effective for strep pneumonia

Disease	Dose	Context	Population
Erysipelas	300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg	First Line	Adult
Erysipelas	<30kg: 300,000 U/day IM; >30kg: 600,000-1 million U/day IM	Pediatric First Line	Pediatric
Ludwig's angina	2-4 million units IV q6 hrs	Immunocompetent	Adult
Ludwig's angina	50,000 units/kg IV q6hrs (max 4 million units)	Pediatric Immunocompetent	Pediatric
Peritonsillar abscess	4 million units (50,000 units/kg) IV four times daily	Inpatient	Adult
Peritonsillar abscess	50,000 units/kg IV q6hrs (max 4 million units/dose)	Pediatric Inpatient	Pediatric
Syphilis	3-4 million units IV every 4 hours x 10-14 days	Neurosyphilis	Adult
Syphilis	50,000 units/kg IV q4-6h x 10-14 days	Congenital Syphilis	Pediatric