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The risk of intramuscular haematoma is low following injection of benzathine penicillin G in patients receiving concomitant anticoagulant therapy

Our local data supports continuing intramuscular injection of BPG in patients with rheumatic heart disease receiving anticoagulant medication

A population pharmacokinetic study of benzathine benzylpenicillin G administration in children and adolescents with rheumatic heart disease

Few children and adolescents receiving BPG as secondary prophylaxis will achieve concentrations >0.02 mg/L for the majority of the time between injections

Acceptability of sonicated versus unsonicated reconstituted (powdered) benzathine penicillin G for rheumatic fever prophylaxis

Powdered benzathine penicillin G (BPG) crystals vary widely in size and shape and are larger and less uniform than crystals found in pre-mixed suspensions of BPG like Bicillin ® L-A.

Controlled Human Infection for Penicillin Against Streptococcus pyogenes – a double blinded randomised trail (The CHIPS trial)

In Australia, RHD-related death and disability is the leading driver of cardiovascular inequality between Indigenous and non-Indigenous Australians.

Subcutaneous infusion of high-dose benzathine penicillin G is safe, tolerable, and suitable for less-frequent dosing for rheumatic heart disease secondary prophylaxis: a phase 1 open-label population pharmacokinetic study

Since 1955, the recommended strategy for rheumatic heart disease secondary prophylaxis has been benzathine penicillin G injections administered intramuscularly every 4 weeks. Due to dosing frequency, pain, and programmatic challenges, adherence is suboptimal. It has previously been demonstrated that BPG delivered subcutaneously at a standard dose is safe and tolerable and has favorable pharmacokinetics, setting the scene for improved regimens with less frequent administration.

Penicillin G concentrations required for prophylaxis against Group A Streptococcus infection evaluated using a hollow fibre model and mathematical modelling

Acute rheumatic fever (ARF), an autoimmune reaction to Group A Streptococcus (Streptococcus pyogenes; Strep A) infection, can cause rheumatic heart disease (RHD). New formulations of long-acting penicillins are being developed for secondary prophylaxis of ARF and RHD.

Stability of benzylpenicillin for continuous intravenous infusions: An isotonic formulation for therapeutic use and a low-dose formulation for clinical trial

The objectives of this study were to develop a stability-indicating high performance liquid chromatography assay for benzylpenicillin in pharmaceutical fluids, and to investigate the stability of (i) isotonic citrate-buffered BPC solutions at the clinically relevant concentration of 30 mg/mL, and (ii) low concentration citrate-buffered BPC intravenous infusions (5–30 μg/mL).

Penicillin Levels for Rheumatic Heart Disease Study – Remote Cohort

Asha Jonathan Bowen Carapetis AM BA MBBS DCH FRACP PhD GAICD FAHMS OAM AM MBBS FRACP FAFPHM PhD FAHMS Head, Healthy Skin and ARF Prevention Executive

Aboriginal children and penicillin injections for rheumatic fever: How much of a problem is injection pain?

We explore young Aboriginal people's and clinicians' experience of injection pain for the 10 years of penicillin injections young people are prescribed.

Severe adverse reactions to benzathine penicillin G in rheumatic heart disease: A systematic review and meta-analysis

Fear of severe adverse reaction (SAR) and reluctance of health care providers to administer intramuscular injections are major contributing factors to poor adherence of benzathine penicillin G (BPG) in the management of rheumatic heart disease (RHD). However, data on the risk of SARs following BPG injections for RHD are relatively limited and inconclusive. Our systematic review and meta-analysis aimed to evaluate the incidence of SARs associated with BPG injections used for secondary prophylaxis of RHD.