Benzylpenicillin in the context of Necrotizing enterocolitis

Penicillins (P, PCN or PEN) are a group of β-lactam antibiotics originally obtained from Penicillium moulds, principally P. chrysogenum and P. rubens. Most penicillins in clinical use are synthesised by P. chrysogenum using deep tank fermentation and then purified. A number of natural penicillins have been discovered, but only two purified compounds are in clinical use: penicillin G (intramuscular or intravenous use) and penicillin V (given by mouth). Penicillins were among the first medications to be effective against many bacterial infections caused by staphylococci and streptococci. They are still widely used today for various bacterial infections, though many types of bacteria have developed resistance following extensive use.

In the United States, 10% of the population claims penicillin allergies, but because the frequency of positive skin test results decreases by 10% with each year of avoidance, 90% of these patients can eventually tolerate penicillin. Additionally, those with penicillin allergies can usually tolerate cephalosporins (another group of β-lactam) because the immunoglobulin E (IgE) cross-reactivity is only 3%.

Treponema pallidum, formerly known as Spirochaeta pallida, is a microaerophilic, gram-negative, spirochaete bacterium with subspecies that cause the diseases syphilis, bejel (also known as endemic syphilis), and yaws. It is known to be transmitted only among humans and baboons. T. pallidum can enter the host through mucosal membranes or open lesions in the skin and is primarily spread through sexual contact. It is a helically coiled microorganism usually 6–15 μm long and 0.1–0.2 μm wide. T. pallidum's lack of both a tricarboxylic acid cycle and processes for oxidative phosphorylation results in minimal metabolic activity. As a chemoorganoheterotroph, Treponema pallidum is an obligate parasite that acquires its glucose carbon source from its host. Glucose can be used not only as a primary carbon source but also in glycolytic mechanisms to generate ATP needed to power the bacterium given its minimal genome. The treponemes have cytoplasmic and outer membranes. Using light microscopy, treponemes are visible only by using dark-field illumination. T. pallidum consists of three subspecies, T. p. pallidum, T. p. endemicum, and T. p. pertenue, each of which has a distinct related disorder. The ability of T. pallidum to avoid host immune defenses has allowed for stealth pathogenicity. The unique outer membrane structure and minimal expression of surface proteins of T. pallidum has made vaccine development difficult. Treponema pallidum can be treated with high efficacy by antibiotics that inhibit bacterial cell wall synthesis such as the beta-lactam antimicrobial penicillin-G.

Procaine benzylpenicillin also known as penicillin G procaine, is an antibiotic useful for the treatment of a number of bacterial infections. Specifically it is used for syphilis, anthrax, mouth infections, pneumonia, diphtheria, cellulitis, and animal bites. It is given by injection into a muscle.

Side effects include pain at the site of injection, blood clotting problems, seizures, and allergic reactions including anaphylaxis. When used to treat syphilis a Jarisch–Herxheimer reaction may occur. It is not recommended in those with a history of penicillin allergy or procaine allergy. Use during pregnancy and breastfeeding is relatively safe. Procaine benzylpenicillin is in the penicillin and beta lactam family of medications. It works via benzylpenicillin and results in bacterial death. Procaine makes the combination long acting.

Penicillium rubens is a species of fungus in the genus Penicillium and was the first species known to produce the antibiotic penicillin. It was first described by Philibert Melchior Joseph Ehi Biourge in 1923. In 1929, Alexander Fleming at St Mary's Hospital, London discovered that the fungus produced an antibiotic that killed bacteria, and named the unknown compound penicillin. For the discovery and development of penicillin, Fleming shared the 1945 Nobel Prize in Physiology or Medicine with Ernst Boris Chain and Howard Florey.

There was long history of controversy on the exact identification of the original penicillin-producing species and was variously identified as Penicillium rubrum, P. notatum, and P. chrysogenum among others. It was only after genomic comparison and phylogenetic analysis in 2011 that the species was resolved as P. rubens. P. rubens is the best source of penicillins such as benzylpenicillin (G), phenoxymethylpenicillin (V) and octanoylpenicillin (K). It also produces another class of antibiotics, cephalosporins. It is also the source of other important bioactive compounds such as andrastin, chrysogine, fungisporin, roquefortine, and sorbicillins.