IMPROVED LOCAL TOLERANCE TO BENZATHINE PENICILLIN G

PEDIATRICS ◽  
1958 ◽  
Vol 21 (2) ◽  
pp. 243-247
Author(s):  
Saul Krugman ◽  
Eva V. Ebin
Keyword(s):  
Intramuscular Injection ◽  
Local Reaction ◽  
Penicillin G ◽  
Benzathine Penicillin ◽  
Local Tolerance ◽  
Procaine Penicillin ◽  
Equal Dose ◽  
Benzathine Penicillin G ◽  
Local Reactions

Four types of penicillin for intramuscular injection were compared for incidence of local reaction: (1) suspension of benzathine penicillin G, 600,000 units in 1 ml; (2) benzathine penicillin G, 600,000 units, with 5 mg of prednisolone, in 1 ml; (3) benzathine penicillin G, 600,000 units, plus aqueous procaine penicillin, 600,000 units, in 2 ml; and (4) aqueous procaine penicillin, 1,200,000 units in 2 ml. A total of 320 children were evaluated at 24 hours, and the following percentages of severe local reaction were recorded for the four penicillin preparations listed: (1) 54%; (2) 9%; (3) 11.5%; and (4) 4%. The incidence of mild local reactions was the same following all four preparations, 11 to 12%. The local tolerance to benzathine penicillin G, 600,000 units, was significantly improved by combining it with either 5 mg of prednisolone, or an equal dose and volume of aqueous procaine penicillin.

Rheumatic Fever Article Questioned

PEDIATRICS ◽  
1984 ◽  
Vol 74 (6) ◽  
pp. 1133-1134
Author(s):  
SYLVIA P. GRIFFITHS
Keyword(s):  
Rheumatic Fever ◽  
Intramuscular Injection ◽  
Group A Streptococcus ◽  
Penicillin G ◽  
Benzathine Penicillin ◽  
Benzathine Penicillin G ◽  
Group A

To the Editor.— The suggestion of Nordin1 that there may be a need to re-evaluate the current recommended prophylaxis for children with rheumatic fever is valid, particularly if carefully planned and controlled studies could be carried out. However, the author's contention that "It has been assumed that the levels of penicillin [following monthly intramuscular injection of 1.2 million units of benzathine penicillin G] are adequate to prevent reinfection with group A streptococcus, and hence to prevent recurrences of rheumatic fever" has always been qualified by others.

Pharmacokinetics of benzathine penicillin G: Serum levels during the 28 days after intramuscular injection of 1,200,000 units

1989 ◽  
Vol 115 (1) ◽  
pp. 146-150 ◽  
Author(s):  
Edward L. Kaplan ◽  
Ximena Berrios ◽  
John Speth ◽  
Thomas Siefferman ◽  
B. Guzman ◽  
...  
Keyword(s):  
Intramuscular Injection ◽  
Serum Levels ◽  
Penicillin G ◽  
Benzathine Penicillin ◽  
Benzathine Penicillin G

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.

scholarly journals UK National Audit of Early Syphilis Management. Clinics audit: screening for and management of early syphilis

2006 ◽  
Vol 17 (5) ◽  
pp. 344-348 ◽  
Author(s):  
Hugo McClean ◽  
David Daniels ◽  
Chris Carne ◽  
Paul Bunting ◽  
Rob Miller ◽  
...  
Keyword(s):  
Contact Tracing ◽  
Penicillin G ◽  
Benzathine Penicillin ◽  
National Audit ◽  
National Guidelines ◽  
Procaine Penicillin ◽  
Early Syphilis ◽  
Benzathine Penicillin G ◽  
Management Policies ◽  
Dark Ground

Data were provided by 131 clinics, and 56% of cases were managed in clinics in the London regions in 2003. Three clinics (2%) do not routinely screen new patients for syphilis, and 28 clinics (21%) do not routinely screen 'rebook' patients who have had a new partner. More than 80% of clinics routinely conduct cardiovascular and neurological examinations, although chest radiography is only performed by 50% of clinics and lumbar puncture by 13%. Only 19 (14%) clinics indicated not routinely using the recommended procaine penicillin G (PPG) regimen or one- or two-dose benzathine penicillin G (BPG) regimens for early syphilis, with 57% providing two doses of BPG 2.4 g, 40% providing PPG 750 mg for 10 days, and 15% providing one dose of BPG 2.4 g. Only seven clinics (5%) indicated that they provided treatment for early syphilis with PPG that is inferior to that recommended in the national guidelines. Only 18 clinics specified using the recommended dose and duration (or in excess of this) of PPG for neurosyphilis for cases with HIV infection. Provision for management of severe penicillin reaction is good, although few patients are desensitized. All clinics report that contact tracing for early syphilis is provided, and is mainly the responsibility of health advisers. Compared with auditing outcomes, audit of management policies overestimated performance in contact tracing and provision of dark ground microscopy.

scholarly journals Inhibiting ability of benzathine penicillin G towards group A Streptococcus β -hemolyticus in 21 and 28 days after a single intramuscular injection

2016 ◽  
Vol 43 (4) ◽  
pp. 136
Author(s):  
Bambang Madiyono ◽  
Mulyadi M Djer ◽  
Sudigdo Sastroasmoro ◽  
Amin Subandrio ◽  
Erni Erfan
Keyword(s):  
Intramuscular Injection ◽  
Group A Streptococcus ◽  
Penicillin G ◽  
Benzathine Penicillin ◽  
Mueller Hinton ◽  
Single Intramuscular Injection ◽  
Benzathine Penicillin G ◽  
Group A ◽  
Preliminary Study ◽  
Mueller Hinton Broth

Background The effectiveness of a single intramuscularbenzathine penicillin G as a secondary prevention of acute rheu-matic fever after 28 days is still controversial. The latest studyshowed that serum penicillin concentration was below protectivelevel in 4 weeks after a single intramuscular injection.Objective This study was a preliminary study to compare the in-hibiting ability of benzathine penicillin G towards group A Strepto-coccus β -hemolyticus in 21 and 28 days after a single IM injectionby using Mueller-Hinton broth method.Methods The inhibiting ability was measured by the serum in-hibitory concentration and serum bactericidal concentration aftera single intramuscular injection of benzathine penicillin G 1.2 mil-lion units.Results The subjects were 28 patients, with mean age of 15.5years (SD 3.4). The numbers of male and female were equal. Meanserum inhibitory concentration in 21 days after a single injectionwas 926.4 (SD 3080.1) and after 28 days was 1540.9 (SD 4275.1),which was not significantly different (p=0.0662). Mean serum bac-tericidal concentration in 21 days after IM injection was 1579.6(SD 4265.7) and in 28 days was 2417 (SD 6849.4) and it was notstatistically different (p=0.2276).Conclusion This study concluded that there was no significantdifference in the inhibiting ability of benzathine penicillin G to-wards group A Streptococcus β -hemolyticus between 21 and 28days after a single intramuscular injection

Serum Penicillin Concentrations After Intramuscular Administration of Benzathine Penicillin G in Children

PEDIATRICS ◽  
1982 ◽  
Vol 69 (4) ◽  
pp. 452-454 ◽  
Author(s):  
Charles M. Ginsburg ◽  
George H. McCracken ◽  
Teresa C. Zweighaft
Keyword(s):  
Penicillin G ◽  
Intramuscular Administration ◽  
Benzathine Penicillin ◽  
Pneumococcal Infections ◽  
Serum Samples ◽  
Procaine Penicillin ◽  
Benzathine Penicillin G ◽  
Group A

Concentrations of penicillin were measured in serum samples of 26 children who received benzathine penicillin G (BPG) alone or in combination with procaine penicillin (PBPG). Both preparations were well absorbed; peak concentrations of penicillin after PBPG administration were 25-fold larger than those after BPG. One third and one half of serum samples from BPG and PBPG patients, respectively, contained no measurable penicillin activity at 18 days. At 30 days, there was no penicillin activity in any of the samples. These data raise questions regarding the use of BPG and PBPG for prophylaxis of group A streptococcal and pneumococcal infections.

scholarly journals Benzathine Penicillin G in the Control of Gonorrhoea

1957 ◽  
Vol 33 (1) ◽  
pp. 40-42
Author(s):  
C. E. Hookings ◽  
L. M. Graves
Keyword(s):  
Penicillin G ◽  
Benzathine Penicillin ◽  
Benzathine Penicillin G
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