Bicillin L-A, also known as Penicillin G benzathine, is a long-acting intramuscular antibiotic injection that is used to treat infections such as syphilis and can be used for the prevention of infections such as rheumatic fever. To reduce the risk of developing bacteria that are resistant to this medication, it should only be used to treat or prevent infections that are proven (or strongly suspected) to be caused by bacteria. If you have a viral infection such as the common cold or the flu, antibiotics wouldn’t help because it targets bacteria and not viruses.

For what types of bacterial infections can Bicillin L-A be used?

It can be given as a single dose to treat pharyngitis or venereal infections such as primary or secondary Syphilis, Yaws, Bejel, and Pinta. Also, it can be used to prevent the recurrence of rheumatic fever or glomerulonephritis (inflammation in the kidneys). It can also be used to treat bacterial infections in infants and children, and the dose depends on their weight. Be aware that there are risks of injury to small children because it is an intramuscular injection. It should not be injected near an artery or nerve because permanent neurological damage or gangrene may occur.

Who should not receive Bicillin L-A?

If you have a true allergy to penicillin, such as anaphylaxis, you should not take this medication or any other penicillin antibiotics, such as amoxicillin. Anaphylaxis is a severe allergic reaction which causes difficulty breathing and shock. Anaphylaxis is a medical emergency, and if not treated immediately, it can result in death. You must call an ambulance. If you have an Epipen, use it immediately when you think you are having anaphylaxis, then call an ambulance. Do not try to get yourself to the emergency room because you may stop breathing on the way there.

What are the side effects of Bicillin L-A?

The most common side effect with this medication is diarrhea. Call your doctor if you have signs of an allergic reaction such as rashes, hives, or wheezing, or signs of a very bad skin reaction like red, swollen, blistered or peeling skin with or without fever. Nerve damage may occur if this medication is given into or near a nerve, so call the doctor if you have any numbness, tingling or weakness. If you very frequent, runny or water bowel movements in a day, or severe belly pain or swelling, or a fever call the doctor because that may be signs of a serious infection known as C. Difficile infection. Also call the doctor if you have trouble passing urine, or have changes in the amount of urine passed because that is a sign that there may be a kidney problem.

How is this medication given?

It is given intramuscularly in the upper outer quadrant of the buttock. Make sure that the medication is warmed to room temperature before it is given to lessen the pain associated with the medication. If it needs to be given again, rotate the injection site. This medication should not be given intravenously, intra-arterially, or subcutaneously (under the skin).

Written by:
Baasit Talebi
PharmD Candidate 2021
Temple University School of Pharmacy