Dose number	Time (min)	#Amount (units/ml)	ml	Units	Cumulative dose in units
1	0	1000	0·1	100	100
2	15	1000	0·2	200	300
3	30	1000	0·4	400	700
4	45	1000	0·8	800	1500
5	60	1000	1·6	1600	3100
6	75	1000	3·2	3200	6300
7	90	1000	6·4	6400	12 700
8	105	10 000	1·2	12 000	24 700
9	120	10 000	2·4	24 000	48 700
10	135	10 000	4·8	48 000	96 700
11	150	80 000	1	80 000	176 700
12	165	80 000	2	160 000	336 700
13	180	80 000	4	320 000	656 700
14	195	80 000	8	640 000	1 296 700
15	225	Parenteral (intravenous) penicillin is given, after which regular doses should be administered for the duration of treatment. Benzathine penicillin (intramuscular) can be given after step 14. Further doses are usually given every 1–3-weekly but a test dose with penicillin V (400 000 U) is given prior to administration of each dose of benzathine penicillin including the first dose after step 14, patient is observed for an hour before administration of benzathine penicillin and further monitoring in hospital overnight is required

Adapted from Wendel et al. [104]. #This treatment must be delivered in an intensive care or high dependency unit. ⁺Obtain informed consent, check pulse, blood pressure and peak expiratory flow rate and repeat prior to every step. Also, monitor patient for signs and symptoms of allergic reaction.