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**Procaine benzylpenicillin** is a depot intramuscular natural penicillin antibiotic comprising the poorly soluble procaine salt of benzylpenicillin. After intramuscular administration, the suspension dissolves slowly, sustaining systemic benzylpenicillin exposure. Benzylpenicillin binds bacterial penicillin-binding proteins and irreversibly inhibits peptidoglycan cross-linking during active bacterial growth, causing osmotic instability and bacterial cell death. Procaine functions as the salt counterion and contributes local anesthetic activity that can lessen injection-site pain. It is used for susceptible bacterial infections in human and veterinary medicine, including streptococcal and pneumococcal infections, skin and soft-tissue infections, syphilis, and selected livestock bacterial infections. It is classified as a natural beta-lactam penicillin antibiotic under ATC code J01CE09.
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