Effect of benzathine penicillin treatment on antibiotic susceptibility of viridans streptococci in oral flora of patients receiving secondary prophylaxis after rheumatic fever

2008 ◽  
Vol 56 (4) ◽  
pp. 244-248 ◽  
Author(s):  
Efraim Bilavsky ◽  
Ruth Eliahou ◽  
Nathan Keller ◽  
Havatzelet Yarden-Bilavsky ◽  
Liora Harel ◽  
...  
Keyword(s):  
Rheumatic Fever ◽  
Antibiotic Susceptibility ◽  
Secondary Prophylaxis ◽  
Benzathine Penicillin ◽  
Viridans Streptococci ◽  
Oral Flora ◽  
Penicillin Treatment

Penicillin and Acute Rheumatic Fever

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 506-507
Author(s):  
Bernard Boxerbaum
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Rheumatic Heart Disease ◽  
Acute Rheumatic Fever ◽  
Secondary Prophylaxis ◽  
Benzathine Penicillin ◽  
Childrens Hospital ◽  
Rheumatic Heart

Introduction of secondary prophylaxis for patients with rheumatic fever is felt to be a major reason for improved prognosis of rheumatic heart disease.1,2(p163) The article by Ginsburg et al,3 raising questions concerning the efficacy of this practice, has prompted me to report our experience in the Rainbow Rheumatic Fever Clinic, Rainbow Babies and Childrens Hospital, where more than 80% of the patients receive 1,200,000 units of benzathine penicillin intramuscularly every 28 days. Seventy percent of the patients with rheumatic mitral regurgitation have lost their murmur, and no patient receiving regular intramuscular prophylaxis has developed stenosis.4

Are the Currently Recommended Doses of Benzathine Penicillin G Adequate for Secondary Prophylaxis of Rheumatic Fever?

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 989-991
Author(s):  
Bart J. Currie
Keyword(s):  
Rheumatic Fever ◽  
Patient Compliance ◽  
Gold Standard ◽  
Health Resources ◽  
Secondary Prophylaxis ◽  
Penicillin G ◽  
Benzathine Penicillin ◽  
Benzathine Penicillin G ◽  
And Storage ◽  
Over 40 Years

Objective. To review the literature on dose and regimens of intramuscular benzathine penicillin G (BPG) for secondary prophylaxis of recurrent rheumatic fever. Setting. For over 40 years BPG has been the gold standard for secondary prophylaxis, usually as a dose of 1 200 000 U (900 mg). Although studies have suggested that BPG injections every 3 weeks are superior to injections every 4 weeks, implementation of an every 3 weeks regimen can be problematic with regards to both patient compliance (adherence) and an increased burden on health resources. Findings. Some of the earliest studies of BPG suggested that larger doses resulted in prolongation of detectable penicillin levels. A recent study assessing plasma penicillin levels after BPG doses of 1 200 000 U, 1 800 000 U, and 2 400 000 U suggested there may be benefits in a BPG regimen every 4 weeks with doses higher than the standard 1 200 000 U. Conclusions. Further studies of higher dose BPG regimens seem justified. In addition, further work is needed on quality and storage options for different BPG preparations; location and method of BPG injections; the importance of weight differences between individuals; and ways of improving access to and compliance with BPG regimens.

Evaluation of DNA damage using the comet assay in children on long-term benzathine penicillin for secondary prophylaxis of rheumatic fever

2001 ◽  
Vol 43 (3) ◽  
pp. 276-280 ◽  
Author(s):  
Ruşen Dündaröz ◽  
Hakan Ulucan ◽  
Metin Denli ◽  
Kasi̇m Karapi̇nar ◽  
Halil İbrahim Aydi̇n ◽  
...  
Keyword(s):  
Dna Damage ◽  
Comet Assay ◽  
Rheumatic Fever ◽  
Secondary Prophylaxis ◽  
Benzathine Penicillin

scholarly journals Sydenham's chorea: clinical and evolutive characteristics

2002 ◽  
Vol 120 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Maria Teresa Ramos Ascensão Terreri ◽  
Suzana Campos Roja ◽  
Claudio Arnaldo Len ◽  
Patricia Corte Faustino ◽  
Adriana Madureira Roberto ◽  
...  
Keyword(s):  
Rheumatic Fever ◽  
Pediatric Rheumatology ◽  
Age At Onset ◽  
Secondary Prophylaxis ◽  
Benzathine Penicillin ◽  
Regular Treatment ◽  
Sydenham’S Chorea ◽  
Rheumatology Unit ◽  
Sydenham's Chorea

CONTEXT: During the last 12 years we have observed an increase in the frequency of Sydenham's chorea in our country. We have observed that some of our patients have presented recurrence of the chorea despite regular treatment with benzathine penicillin. OBJECTIVE: The aim of our study was to evaluate clinical and evolutive characteristics of Sydenham's chorea in a group of patients followed in our Pediatric Rheumatology Unit. TYPE OF STUDY: Retrospective study. SETTING: Section of Pediatric Rheumatology - Discipline of Allergy, Clinical Immunology and Rheumatology - Department of Pediatrics - UNIFESP - EPM. PARTICIPANTS: Two hundred and ninety patients with rheumatic fever followed between 1986 and 1999. METHODS: We reviewed the records of 290 patients with rheumatic fever followed between 1986 and 1999. All patients were diagnosed according to the revised Jones criteria (1992). We included 86 patients that presented Sydenham's chorea as one of the major criteria (one or more attacks) and evaluated their clinical and evolutive characteristics as well the treatment. RESULTS: Fifty-five patients were girls and 31 were boys. The mean age at onset was 9.7 years and mean follow-up period was 3.6 years. The 86 Sydenham's chorea patients presented 110 attacks of chorea. We observed isolated chorea in 35% of the patients, and 25 (29%) presented one or more recurrences. We included only 17 of the 25 patients for further analysis, with a total of 22 recurrences of which 14 were attacks of chorea, because it was not possible to precisely detect the interval between attacks in the other patients. The approximate interval between the attacks ranged from 4 to 96 months. In 71% of the patients there was no failure in the secondary prophylaxis with benzathine penicillin, which was performed every 3 weeks. CONCLUSION: Despite the regular use of secondary benzathine penicillin prophylaxis, children with rheumatic fever have a high risk of Sydenham's chorea recurrence.

scholarly journals Non adherence to secondary prophylaxis for rheumatic fever

2020 ◽  
Vol 7 (11) ◽  
pp. 2101
Author(s):  
Santosh K. Saha ◽  
Kamrun N. Choudhury ◽  
Nihar R. Sarker ◽  
Gias U. Ahmed ◽  
Nazmul Hoque
Keyword(s):  
Rheumatic Fever ◽  
Previous History ◽  
Cost Effective ◽  
Secondary Prophylaxis ◽  
Penicillin G ◽  
P Value ◽  
Benzathine Penicillin ◽  
Female Ratio ◽  
Benzathine Penicillin G ◽  
One Year

Background: Secondary prophylaxis with benzathine penicillin G (BPG) is a cost-effective intervention for preventing morbidity and mortality related to rheumatic fever (RF). There is no reliable data available with regards to adherence to secondary prophylaxis and rates of recurrent RF in many developing countries, including Bangladesh. So, aim of this study was to estimate rate of non-adherence and find out risk of non-adherence to secondary prophylaxis for rheumatic fever.Methods: Total 230, 5-30 years patients of both sexes with definite previous history of RF taking secondary prophylaxis with injection benzathine penicillin G (BPG) were enrolled by simple random fashion. Last one-year injection profile of the patient was collected from the injection card. Patients were then classified as “non-adherent” when the rate of adherence was <80% of the expected injections and as “adherent” when it was ≥80%. After collection of data selective patients were invited for blood tests and echocardiography to identify recurrence of rheumatic fever.  Results: Out of 230 patients, male were 96 (41.7%) and female were 134 (58.3%). Male and female ratio were 0.7. 173 (75.2%) were adherent with benzathine penicillin and 57 (24.8%) patients not adherent with benzathine penicillin. In adherent group only 5 (2.2%) and in non-adherent group 19 (8.3%) patients develop rheumatic recurrence and this finding was statistically significant (p-value 0.001).  Conclusions: Non adherence to secondary prophylaxis with BPG was found a major risk factor for recurrent rheumatic fever. The main reasons of non-adherence were lack of counselling, fare of pain and fail to remember. 

Sister-chromatid exchange analysis on long-term benzathine penicillin for secondary prophylaxis of rheumatic fever

2001 ◽  
Vol 68 (2) ◽  
pp. 121-122 ◽  
Author(s):  
RuŞen Dündaröz ◽  
Tahir Ozisik ◽  
Volkan Baltaci ◽  
Kasim Karapinar ◽  
Halil Ibrahim Aydin ◽  
...  
Keyword(s):  
Rheumatic Fever ◽  
Sister Chromatid ◽  
Sister Chromatid Exchange ◽  
Secondary Prophylaxis ◽  
Benzathine Penicillin

Three-Versus Four-week Administration of Benzathine Penicillin G: Effects on Incidence of Streptococcal Infections and Recurrences of Rheumatic Fever

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 984-988
Author(s):  
Hung-Chi Lue ◽  
Mei-Hwan Wu ◽  
Jou-Kou Wang ◽  
Fen-Fen Wu ◽  
Yu-Nian Wu
Keyword(s):  
Rheumatic Fever ◽  
Color Doppler ◽  
Clinic Visit ◽  
Penicillin G ◽  
Controlled Study ◽  
Streptococcal Infections ◽  
Benzathine Penicillin ◽  
Acute Phase Reactants ◽  
Weight Percentage ◽  
Benzathine Penicillin G

Objective. To investigate the effects of 3-week versus 4-week administration of benzathine penicillin G (BPG) on the incidence of Group A streptococcal infections and the recurrences of rheumatic fever (RF). Study Design. We started, in 1979, randomly allocating all patients with RF to a 3-week or 4-week BPG prophylaxis program. They were examined at the RF clinic, every 3 to 6 months, and at any time they did not feel well. During 1979 to 1989, throat cultures and sera for antistreptolysin O and streptozyme titers were obtained at each clinic visit. Chest radiographs, electrocardiogram, color Doppler echocardiograms, and acute phase reactants were obtained. Subjects. Two hundred forty-nine patients fulfilled the revised Jones criteria and were followed until December 1991: 124 in the 3-week and 125 in the 4-week program. Their age, sex, weight, percentage with history of RF, severity of cardiac involvement, follow-up duration, and compliance to program were comparable. Eight hundred eighty throat cultures were collected in the 3-week program and 770 were collected in the 4-week program. Six hundred sixteen and 627 sera were determined in each program for antistreptolysin O, and 582 and 592 sera for streptozyme titers. Results. True streptococcal infections occurred in both programs: 39 infections in the 3-week program, and 59 infections in the 4-week program (7.5 vs 12.7 per 100 patient-years). Four infections with no antibody response occurred in the 3-week program, and three such infections in the 4-week program. Nine RF recurrences occurred in 8 patients in the 3-week program, and 16 recurrences in 16 patients in the 4-week program. Prophylaxis failure occurred in 2 of 124 patients in the 3-week program, and in 10 of 125 patients in the 4-week program (0.25 vs 1.29 per 100 patient-years). The overall recurrences/infections rate in each program was comparable, 13.6% vs 15.5%, but the recurrences/infections rate due to prophylaxis failure was higher in the 4-week program than in the 3-week program, 3.0% versus 9.7%. Conclusions. This 12-year prospective and controlled study documented that streptococcal infections and RF recurrences occurred more often in the 4-week program than in the 3-week program. The risk of prophylaxis failure was fivefold greater in the 4-week program than in the 3-week program.

Treatment of Acute Streptococcal Pharyngitis and Prevention of Rheumatic Fever: A Statement for Health Professionals

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 758-764 ◽  
Author(s):  
Adnan Dajani ◽  
Kathryn Taubert ◽  
Patricia Ferrieri ◽  
Georges Peter ◽  
Stanford Shulman ◽  
...  
Keyword(s):  
Rheumatic Fever ◽  
Antimicrobial Prophylaxis ◽  
Cost Effective ◽  
Streptococcal Pharyngitis ◽  
Secondary Prophylaxis ◽  
Therapeutic Modalities ◽  
Proven Efficacy ◽  
Group A ◽  
Risk Of Exposure ◽  
The Individual

Primary prevention of acute rheumatic fever is accomplished by proper identification and adequate antibiotic treatment of group A β-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of GAS pharyngitis is best accomplished by a throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) remains the treatment of choice, because it is cost effective, has a narrow spectrum of activity, has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. Various macrolides, oral cephalosporins, and other β-lactam agents are acceptable alternatives, particularly in penicillin-allergic individuals. The individual who has had an attack of rheumatic fever is at very high risk of developing recurrences after subsequent GAS pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The duration of prophylaxis depends on the number of previous attacks, the time lapsed since the last attack, the risk of exposure to streptococcal infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or erythromycin are acceptable alternatives in penicillin-allergic individuals. This report is an update of a 1988 statement by this committee. It expands on the previous statement, includes more recent therapeutic modalities, and makes more specific recommendations for the duration of secondary prophylaxis.

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