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

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

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

Allergic Reactions in Rheumatic Fever Patients on Long-term Benzathine Penicillin G: The Role of Skin Testing for Penicillin Allergy

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 981-983
Author(s):  
Milton Markowitz ◽  
Hung-Chi Lue
Keyword(s):  
Developing Countries ◽  
Rheumatic Fever ◽  
The United States ◽  
World Health ◽  
Penicillin G ◽  
Allergic Reactions ◽  
Benzathine Penicillin ◽  
Benzathine Penicillin G ◽  
The Impact

An injection of 1.2 million U benzathine penicillin G (BPG) every 3 or 4 weeks has proven by far to be the most effective method to prevent recurrences of acute rheumatic fever.1-3 The efficacy of this method of prophylaxis was first demonstrated more than 40 years ago, and since its introduction, it has played a major role in reducing the morbidity and mortality from rheumatic fever.4 Rheumatic fever causes 25% to 40% of all cardiovascular diseases in developing countries.5 Because of the impact of this disease on public health, the World Health Organization (WHO) has helped establish programs for prevention of recurrent attacks of rheumatic fever in many developing countries.6 WHO recommends BPG as the prophylactic drug of choice. One of the problems encountered has been the high drop-out rates among patients enrolled in these programs. Among the reasons for discontinuing prophylaxis is the fear of an allergic reaction.7 The initial study using BPG for the prevention of recurrences of rheumatic fever in children and adolescents reported only 5 (1.2%) mild allergic reactions among 410 patients receiving monthly injections.1 Since then, although rheumatic fever prevention in the United States (U.S.) has consisted almost exclusively of using BPG, there been very few documented reports of serious allergic reactions in rheumatic fever patients on long-term prophylaxis. The only fatalities reported in the American literature occurred in four adults with advanced rheumatic heart disease.8,9 The salutary experience with BPG in the U.S. contrasts sharply with the numerous anecdotal reports of fatal allergic reactions to BPG in many developing countries.

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.

scholarly journals Allergic reaction to long – term Benzathine penicillin injection for secondary prevention of acute rheumatic fever and recommendations for skin testing

2013 ◽  
Vol 8 (1) ◽  
pp. 16-18 ◽  
Author(s):  
PR Regmi ◽  
AB Upadhyaya
Keyword(s):  
Secondary Prevention ◽  
Allergic Reaction ◽  
Rheumatic Fever ◽  
Skin Testing ◽  
Control Programme ◽  
Allergic Reactions ◽  
Benzathine Penicillin ◽  
Batch Number ◽  
Study Results

Background Rheumatic Fever (RF) causes 25-40% of all cardio vascular disease in developing countries. Long term benzathine penicillin injection is being used for secondary prophylaxis of RF / RHD. Although allergic reaction to penicillin is rare skin testing is performed routinely before each and every penicillin injection delivery in most of the hospitals in Nepal. Objectives Objectives of this study was to evaluate safety of long term benzathine penicillin injection and establish recommendations for penicillin skin testing. Methods Data from the registers of National RF/RHD prevention and control programme from 32 hospitals of Nepal were collected and analyzed in a retrospective study. Results 65 patients (1.4%) among 77300 injections of benzathine penicillin given to 4712 patients, had allergic reactions. 5 had anaphylaxis, an incidence of 0.1% (0.7/10000 injections), 60 had minor allergy, an incidence of 1.3%. Conclusions Life-threatening allergic reactions are very rare in patients on long-term intramuscular benzathine penicillin for secondary prevention of RF. With these rare complications, regular skin test before each and every benzathine penicillin injection delivery has no significant role. Nevertheless Skin testing is recommended before 1st injection and patients having different batch number and or brand name. DOI: http://dx.doi.org/10.3126/njh.v8i1.8331 Nepalese Heart Journal Vol.8(1) 2011 pp.16-18

Rheumatic fever

2013 ◽  
pp. 826-836
Author(s):  
Andrew Steer
Keyword(s):  
Rheumatic Fever ◽  
Group A Streptococcus ◽  
Premature Mortality ◽  
Secondary Prophylaxis ◽  
Group A ◽  
Inflammatory Drugs ◽  
Considerable Morbidity ◽  
Rheumatic Valvular Disease ◽  
Term Management

Rheumatic fever is an autoimmune inflammatory condition that follows infection with the group A streptococcus. It is a common condition in tropical developing countries, but has become a rare disease in developed temperate countries. The most frequent clinical presentation of rheumatic fever is fever and arthritis, often with carditis. The carditis, which manifests as a valvulitis, can progress to rheumatic valvular disease. Rheumatic heart disease is a chronic and disabling condition associated with considerable morbidity and premature mortality. Management of rheumatic fever includes treatment of the inflammation of the disease using aspirin or other non-steroidal anti-inflammatory drugs and assessment and management of any cardiac involvement. Secondary prophylaxis is the mainstay of long-term management and patients usually require antibiotic prophylaxis for many years after the initial episode.

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