Aseptic myonecrosis following intramuscular benzathine penicllin G injection: a novel syndrome

Diagnosis ◽  
2017 ◽  
Vol 4 (1) ◽  
pp. 51-54 ◽  
Author(s):  
Nicholas Ryan ◽  
Andrew Olson
Keyword(s):  
Side Effects ◽  
Injection Site ◽  
Pediatric Patient ◽  
Similar Case ◽  
Streptococcal Pharyngitis ◽  
Penicillin G ◽  
Injection Site Pain ◽  
Benzathine Penicillin ◽  
Benzathine Penicillin G ◽  
Site Pain

AbstractWe report a novel syndrome of aseptic myonecrosis in a child occurring after intramuscular (IM) benzathine penicillin G injection for the treatment of streptococcal pharyngitis. Common side effects of IM injection, including transient injection site pain and inflammation, are common and well described. However, isolated myonecrosis following IM injection in the pediatric patient has not been previously reported. Only one similar case, following IM diclofenac injection, has been discussed in the adult literature.

A Review of the Rationale and Advantages of Various Mixtures of Benzathine Penicillin G

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 960-963
Author(s):  
James W. Bass
Keyword(s):  
Clinical Response ◽  
Gold Standard ◽  
Streptococcal Pharyngitis ◽  
Penicillin G ◽  
Benzathine Penicillin ◽  
Cure Rate ◽  
Parenteral Treatment ◽  
Benzathine Penicillin G ◽  
Local Reactions

Intramuscular benzathine (BZ) penicillin G has been accepted as the gold standard for treatment of patients with streptococcal pharyngitis since it was first introduced in 1952. Unfortunately, it has been associated with pain and tenderness at the site of injection. Efforts to lessen this by combining it with varied quantities of procaine (PC) penicillin G have been successful, decreasing the incidence of significant local reactions to 5% to 10%, little more than that seen with PC penicillin alone. A preparation containing 600 000 U BZ penicillin G and 600 000 U PC penicillin in 2 mL has been marketed since the mid-1950s as CR Bicillin 600/600 but the content of BZ penicillin G has been considered adequate only for children who weigh <60 pounds. This prompted the evaluation of a preparation containing 900 000 U BZ penicillin G plus 300 000 U PC penicillin G in a 2-mL injection. Of 400 children with streptococcal pharyngitis 100 each received this preparation, 600 000 U BZ penicillin G alone in 1 mL, 1.2 million U BZ penicillin G alone in 2 mL or 600 000 U BZ penicillin G plus 600 000 U PC penicillin G in 2 mL Clinical response was equal in all four groups; all patients were well in 36 to 48 hours. The two preparations containing PC penicillin G had significantly less severe local reactions and throat cultures were negative in all by 48 hours; it remained positive in some patients who received BZ penicillin G alone after 72 hours. The cure rate in patients receiving the 900 000/300 000 combination of BZ and PC penicillin G was equal to that in patients who received 1.2 million U BZ penicillin G with these added advantages. This combination offers optimal parenteral treatment for streptococcal pharyngitis in all children who weigh <140 pounds and it has been marketed for this purpose since 1976.

COVID-19 Vaccine and Fitness to Fly

2021 ◽  
Vol 92 (9) ◽  
pp. 698-701
Author(s):  
Daniel Gabbai ◽  
Aya Ekshtein ◽  
Omer Tehori ◽  
Oded Ben-Ari ◽  
Shachar Shapira
Keyword(s):  
Side Effects ◽  
Injection Site ◽  
Air Force ◽  
Side Effect ◽  
Common Side Effect ◽  
Injection Site Pain ◽  
Dose Administration ◽  
The Difference ◽  
Site Pain ◽  
The U.S

INTRODUCTION: On December 2020 the U.S. Food and Drug Administration (FDA) authorized the emergency use of Pfizer-BioNTech COVID-19 vaccine. This new vaccine has several side effects that can potentially impair function, which warrants special attention regarding aircrews fitness to fly following vaccination.METHODS: A survey was conducted in the Israeli Air Force (IAF) Aeromedical Center in order to characterize the side effects and their duration following Pfizer-BioNTech COVID-19 vaccine administration to aviators.RESULTS: The most common side effect was injection site pain. Headache, chills, myalgia, fatigue, and weakness were more common following the second dose administration. The difference is statistically significant. Following the second vaccine, duration of side effects was longer compared to the first vaccine (P-value 0.002).CONCLUSION: The IAF Aeromedical center policy for Pfizer-BioNTech COVID-19 vaccine recipients among aircrew members, based on side effects duration and severity, is to temporarily ground from flight duties for 24 and 48 h following the first and the second dose, respectively.Gabbai D, Ekshtein A, Tehori O, Ben-Ari O, Shapira S. COVID-19 vaccine and fitness to fly. Aerosp Med Hum Perform. 2021; 92(9):698701.

ANTIBIOTICS IN THE TREATMENT OF BETA-HEMOLYTIC STREPTOCOCCAL PHARYNGITIS: FACTORS INFLUENCING THE RESULTS

PEDIATRICS ◽  
1960 ◽  
Vol 25 (1) ◽  
pp. 27-34
Author(s):  
Maxwell Stillerman ◽  
S. H. Bernstein ◽  
Martha L. Smith ◽  
Stanley B. Gittelson ◽  
Samuel Karelitz
Keyword(s):  
Clinical Manifestations ◽  
Streptococcal Pharyngitis ◽  
Penicillin G ◽  
Benzathine Penicillin ◽  
Cure Rate ◽  
Penicillin V ◽  
Significant Difference ◽  
Penicillin Therapy ◽  
Benzathine Penicillin G ◽  
Oral Doses

The effectiveness of penicillin V, penicillin V potassium, benzathine penicillin G, erythromycin and tetracycline in eradicating beta-hemolytic streptococci from the pharynx of 410 infected patients or carriers was studied. Penicillin V and penicillin V potassium were administered in daily oral doses of 375 to 750 mg (600,000 and 1,200,000 units), respectively, for 10 days. The benzathine penicillin G was injected once intramuscularly in similar doses. The broad spectrum antibiotics were given in daily oral doses of 30 to 50 mg/kg, up to 1 gm, for 10 days. The bacterial cure rate was 84% for 224 patients treated with penicillin V and penicillin V potassium, and 86% for 129 patients treated with benzathine penicillin G in combined doses. Forty-eight percent of 23 patients treated with erythromycin and 38% of 34 patients treated with tetracycline were cured. The majority of the clinical bacterial relapses developed 14 to 28 days after the onset of treatment with penicillin V orally and 24 to 32 days after benzathine penicillin G, 375 mg intramuscularly. Approximately half of the patients with bacterial relapses had clinical manifestations of pharyngitis. Factors which might be responsible for the development of relapses and failures are discussed. Complications consisted of one case of otitis media and one case of glomerulonephritis, developing 12 and 22 days, respectively, after the onset of treatment. No case of rheumatic fever was observed. The data indicate that penicillin was definitely more effective than erythromycin and tetracycline in eradiating beta-hemolytic streptococci from the host, in the doses used. There was no significant difference in the effectiveness of penicillin V, penicillin V potassium and benzathine penicillin G. Attention is drawn to the relapse-and-failure rate of 15% in these patients despite penicillin therapy.

Efficacy of benzathine penicillin G in group A streptococcal pharyngitis: Reevaluation

1987 ◽  
Vol 110 (5) ◽  
pp. 783-787 ◽  
Author(s):  
Sandor Feldman ◽  
Alan L. Bisno ◽  
Lennie Lott ◽  
Richard Dodge ◽  
Rachel E. Jackson
Keyword(s):  
Streptococcal Pharyngitis ◽  
Penicillin G ◽  
Benzathine Penicillin ◽  
Benzathine Penicillin G ◽  
Group A

scholarly journals Side Effects and Perceptions Following Sinopharm COVID-19 Vaccination

2021 ◽  
Author(s):  
Balsam Qubais ◽  
Rula Al-Shahrabi ◽  
Shaikha Salah Alhaj ◽  
Zainab Mansour Alkokhardi ◽  
Ahmed Omar Adrees
Keyword(s):  
Side Effects ◽  
Injection Site ◽  
Demographic Data ◽  
Survey Study ◽  
Vaccine Hesitancy ◽  
Injection Site Pain ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Vaccination Site ◽  
Site Pain

Objectives Vaccines are one of the best interventions developed for eradicating COVID-19 the rapid creation of vaccinations was increased the risk of vaccine safety problems. The aim of this study to provide evidence on Sinopharm COVID-19 vaccine side effects. Methods A cross-sectional survey study was conducted between January and April 2021 to collect data on the effects of COVID-19 vaccine among individuals in the UAE. Demographic data chronic conditions side effects of the 1st and 2nd dose toward the vaccination, and the response of unwilling taking COVID-19 vaccine were reported. Results The most common side effects of post 1st dose (less than 49 years old vs >49 years) were normal injection site pain, fatigue, and headache while pain at the vaccination site fatigue lethargy headache and tenderness were the most side effects of the post 2nd dose in both groups. All the side effects in both doses were more prevalent among the participants less than 49-year-old group. Among females vs males side effects were more common in females compared with males in both doses in both doses. The most common adverse reactions of 1st dose in (females vs males) were fatigue lethargy headache while in 2nd dose were fatigue sever injection site pain. The most common reason of not willing to take the COVID-19 vaccine were the vaccines are not effective and they were not authorized to take vaccine. Conclusion The 1st and 2nd dose post-vaccination side effects were mild predictable and there were no hospitalization cases this data will help to reduce the vaccine hesitancy.

OBSERVATIONS ON AN EPIDEMIC OF STREPTOCOCCAL INFECTIONS AND RECURRENCES OF RHEUMATIC FEVER AMONG CHILDREN TREATED WITH PENICILLIN

PEDIATRICS ◽  
1957 ◽  
Vol 20 (2) ◽  
pp. 257-267
Author(s):  
Milton Markowitz
Keyword(s):  
Oral Dose ◽  
Rheumatic Fever ◽  
Streptococcal Pharyngitis ◽  
Penicillin G ◽  
Streptococcal Infections ◽  
Benzathine Penicillin ◽  
Daily Oral Dose ◽  
Intramuscular Dose ◽  
Small Series ◽  
Benzathine Penicillin G

An outbreak of streptococcal pharyngitis among children in a convalescent hospital has been described. Eleven of thirty-three subjects with rheumatic fever, under close observation, developed group A streptococcal infections while they received a single daily oral dose of 200,000 units of benzathine penicillin G. Treatment of the streptococcal infections was carried out with therapeutic doses of various penicillin preparations. Four children who received single injections of 600,000 units of benzathine penicillin G, developed recurrences of rheumatic fever. The results of the study indicate that a single daily oral dose of 200,000 units of benzathine penicillin G is inadequate for the prevention of streptococcal infections in a closed or semiclosed community of rheumatic fever subjects. It is suggested that at least twice this dosage be employed in such an environment. The data based on a small series of cases suggest that the treatment of acute streptococcal infections with a single intramuscular dose of 600,000 units of benzathine penicillin G will not prevent recurrences of rheumatic fever in highly susceptible patients.

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