Comparative Pharmacology
Head-to-head clinical analysis: BICILLIN C R versus TOTACILLIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BICILLIN C R versus TOTACILLIN.
BICILLIN C-R vs TOTACILLIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Benzathine penicillin G and procaine penicillin G are beta-lactam antibiotics that inhibit bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), inhibiting transpeptidase activity, and activating autolytic enzymes, leading to cell lysis.
Bactericidal: inhibits cell wall synthesis by binding to penicillin-binding proteins (PBPs), inhibiting transpeptidation. Active against gram-positive bacteria and some gram-negative bacteria.
1.2 million units intramuscularly as a single dose (600,000 units procaine penicillin G and 600,000 units benzathine penicillin G) for moderate to severe infections; for mild infections, 600,000 units intramuscularly as a single dose.
250-500 mg orally every 6 hours or 1-2 g intravenously every 4-6 hours.
None Documented
None Documented
Penicillin G: 0.5-1 hour in normal renal function; prolonged to 7-10 hours in anuria. Benzathine component sustains low levels for days; effective half-life of benzathine penicillin G is 3-5 days due to slow release.
Terminal elimination half-life: 1.0-1.5 hours in normal renal function. Extended to 2-6 hours in renal impairment; requires dose adjustment when CrCl <30 mL/min.
Renal excretion primarily via glomerular filtration and tubular secretion; approximately 60-70% of penicillin G is excreted unchanged in urine within 6 hours; benzathine and procaine components are metabolized and excreted renally as well; small amounts in bile and feces.
Renal: 90-95% unchanged via glomerular filtration and tubular secretion. Biliary/fecal: <5% as unchanged drug and metabolites.
Category C
Category C
Penicillin Antibiotic
Penicillin Antibiotic