Penicillin Primer for Preppers

My children love to play all kinds of games.  While I favor the more regular, competitive-type board games, some of them have gotten into cooperative-type games where the character they play has superpowers.  I understand they enjoy playing the games, and that's great.  I guess a lot of people wish they had incredible superpowers to make their lives easier or wipe out the bad guys.  Maybe if I had a cool superpower, I'd enjoy stuff like that, too.  I just got the garden variety superpower that most moms have--the death glare for teenagers.  It works pretty well, but you know, it's not very exciting.

Penicillin, discovered in the 1920s by Alexander Fleming and first used clinically in the early 1940s, was heralded as the first "miracle" drug.  While hundreds and thousands of others have followed, penicillin is the one that started it all.  Penicillin's superpower lies in preventing bacteria from building and repairing cell walls.  Water flows into the bacterial cells, and the cells swell up and die.  Penicillin-resistant bacteria survived by learning how to defeat that mechanism of action.

Penicillin comes in several forms.  They cannot necessarily be used interchangeably.

• Benzylpenicillin (penicillin G) is the original penicillin found in 1928.  It is administered by intramuscular or intravenous injection.  This is the best for severe streptococcal pneumonia and Neisseria infections in the chest, meningitis, and cellulitis.
• Benzathine penicillin acts for a longer time than benzylpenicillin.  It is administered by intramuscular injection.  The benzathine is a stabilizer that slows the release of penicillin so that it remains in the body for two to four weeks.
• Procaine penicillin also acts for a longer time than benzylpenicillin.  This is another slow-release penicillin administered by intramuscular injection.
• Phenoxymethylpenicillin (penicillin V or VK) is the only form that can be taken orally.  It is less effective against Gram-negative bacteria.  It comes in two different strengths, 250 mg and 500 mg.  One company markets these capsules as Fish-Pen (250 mg) and Fish-Pen Forte (500 mg).  This preparation works well for strep throat due to Streptococcus pyogenes or Group A strep. 

Penicillin doesn't make the top five or ten list of antibiotics to stockpile for most physicians.  It's a narrow-spectrum antibiotic to which many bacteria have developed resistance.  However, it does have a couple of significant advantages, and it's not all that expensive to acquire.  The first is that penicillin penetrates very well into the central nervous system.  It's a good choice for bacterial meningitis infections, but it has to be started very quickly.  The second is that it is considered safe for pregnant and breastfeeding women. 

Penicillin is useful for upper respiratory tract infections due to Streptococcus pneumoniae, but it is not the first choice doctors turn to because there are so many other bacteria that cause URIs, and the antibiotics that treat those will also cover Streptococcus pneumoniae. Penicillin is also a good choice for dental infections. 

When treating various bacterial infections with penicillin, physicians will prescribe along the lines of the following:

• upper respiratory tract, including sore throat due to bacterial infection, 250-500 mg every 6 hours, until there has been no fever for at least 2 days
• scarlet fever, 250 mg every 6 hours, for 10 days
• ear infection, 250-500 mg every 6 hours, until there has been no fever for at least 2 days
• cutaneous or inhalation anthrax, 500 mg every 6 hours, for 10 days in "normal" situations, or up to 60 days in the case of bioterrorism
• dog bites, 500 mg every six hours, for 3-5 days
• diphtheria, 250-500 mg every 6 hours, for 14 days

Penicillin is not generally effective for cellulitis, nor does it work well on other skin infections, or insect bites or stings.

Adverse reactions to penicillin are not uncommon.  These include diarrhea, nausea, rash, hives, and secondary fungal infections.  An adverse reaction may or may not be a precursor to a future allergic reaction and should be noted in medical records.


A true allergic reaction to penicillin occurs in less than one-tenth of one percent of patients.

Alternatives for those allergic to penicillin include the following:

• azithromycin
• ciprofloxacin
• clindamycin
• doxycycline 
• erythromycin
• metronidazole
• minocycline
• sulfa drugs
• tetracycline 

Those without antibiotics or with sensitivities to penicillin may benefit from using Usnea.  

Links to related posts:
Allergic to Penicillin?  What Are the Options? 
DIY Penicillin--Do You Really Want To Go There?   
Usnea  

For further reading:  

Armageddon Medicine 
Alton's Antibiotics, pp 127 and 156 
Survival and Austere Medicine, 3rd Edition, p 209

 11 february 2020