Administration Of Benzathine Penicillin Research Articles

Team adherence to rapid prenatal testing and administration of benzathine penicillin in primary healthcare.

To identify the factors related to the work process regarding the adherence of Primary Healthcare teams to the rapid test for HIV, syphilis, hepatitis B and C during prenatal care and administration of benzathine penicillin in primary healthcare. A descriptive, exploratory and quantitative study conducted between the months of July and November 2018, with professionals from the Family Health Strategy teams of the Seridó Norte-Rio-Grandense region in Rio Grande do Norte State, Brazil. There were 18 municipalities, 94 Basic Health Units and 100 Family Health Strategy teams which participated in the study. The nurse was the main person involved in the testing service, and 93% of the interviewed teams offered the test in the service routine. Of these teams, 97.8% underwent prenatal testing, 51.6% offered the test to the pregnant woman at the beginning of the third trimester, and 57% offered the rapid test to sexual partners. Benzantine penicillin was available in 87.1% of the teams; however, 49.5% did not administer the medication in primary healthcare. The testing process proved to be fragile because even if the test was available in prenatal care, the other activities linked to the work process did not occur properly.

Availability and administration of benzathine penicillin G for the prevention of rheumatic fever in Africa: report of the Working Group on Penicillin, Pan-African Society of Cardiology Task Force on Rheumatic Heart Disease

Availability and administration of benzathine penicillin G for the prevention of rheumatic fever in Africa: report of the Working Group on Penicillin, Pan-African Society of Cardiology Task Force on Rheumatic Heart Disease

Penicillin Dried Blood Spot Assay for Use in Patients Receiving Intramuscular Benzathine Penicillin G and Other Penicillin Preparations To Prevent Rheumatic Fever.

Rheumatic heart disease (RHD) remains an important global health challenge. Administration of benzathine penicillin (BPG) every 3 to 4 weeks is recommended as a secondary prophylaxis to prevent recurrent episodes of acute rheumatic fever and subsequent RHD. Following intramuscular injection, BPG is hydrolyzed to penicillin G (benzylpenicillin). However, little is known of the pharmacokinetics (PK) of BPG in pediatric populations at high risk of RHD or of the pharmacokinetic-pharmacodynamic relationship between penicillin exposure and clinically relevant outcomes. Dried blood spot (DBS) assays can facilitate PK studies in situations where frequent venous blood sampling is logistically difficult. A liquid chromatography-mass spectroscopy assay for penicillin G in plasma and DBS was developed and validated. Application of the DBS assay for PK studies was confirmed using samples from adult patients receiving penicillin as part of an infection management plan. The limit of quantification for penicillin G in DBS was 0.005 mg/liter. Penicillin G is stable in DBS for approximately 12 h at room temperature (22°C), 6 days at 4°C, and >1 month at -20°C. Plasma and DBS penicillin G concentrations for patients receiving BPG and penicillin G given via bolus doses correlated well and had comparable time-concentration profiles. There was poor correlation for patients receiving penicillin via continuous infusions, perhaps as a result of the presence of residual penicillin in the peripherally inserted central catheter, from which the plasma samples were collected. The present DBS penicillin G assay can be used as a surrogate for plasma concentrations to provide valid PK data for studies of BPG and other penicillin preparations developed to prevent rheumatic fever and RHD.

Advice to health professionals: Use of lignocaine as a diluent to reduce the pain associated with the administration of benzathine penicillin G

Advice to health professionals: Use of lignocaine as a diluent to reduce the pain associated with the administration of benzathine penicillin G

Advice to health professionals: Use of lignocaine as a diluent to reduce the pain associated with the administration of benzathine penicillin G

To the Editor : Rheumatic heart disease (RHD) is a consequence of untreated group A beta-haemolytic streptococcal pharyngitis in a susceptible individual who is likely to live under social conditions of poverty. There are over 30 million people with the disease, which is associated with over 300 000 deaths per year worldwide. In Mozambique and South Africa, RHD is estimated to affect 20 - 30/1 000 asymptomatic schoolchildren. Intramuscular penicillin is more effective than oral penicillin in the secondary prevention of acute rheumatic fever (ARF), and is highly effective for the primary prevention of ARF in children and young adults with pharyngitis. Intramuscular benzathine penicillin G (BPG) is therefore a first-line drug for primary and secondary prevention of ARF and RHD.

Outcomes of Cardiac Catheterisation Procedures in Indigenous Australians

commonly affected and no patients had a previous history of rheumatic heart disease. Cardiac clinic followup isnowhigh,with 82%ofpatients attending for further consultations. Previous “no-show” rates for outsourced cardiology referrals, including for echocardiography, was up to 90%. Conclusion:Portable 2D-echocardiography is a valuable add-on to the on-site cardiology clinic within the AMS and detects high rates of pathology as well as improving patient follow up. http://dx.doi.org/10.1016/j.hlc.2013.05.602 601 Key Factors Influencing Primary Health Service Performance in Prevention Of Recurrent ARF and RHD M. Fittock ∗, K. Edwards NT RHD Control Program, Northern Territory, Australia Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain important causes of illness and prematuredeathamongchildrenandyoungadults inAustralian Indigenous populations. Rheumatic fever became a notifiable condition in 1995 in the Northern Territory (NT) and subsequently the NT RHD Register and the NT RHD Control Program was established to provide a website interface data repository to capture a clinical patient reporting system for rheumatic fever episodes. The primary role of the Control Program is to collaboratively and systematically work with primary health care (PHC) services to improve secondary prophylaxis adherence rates. Secondary prevention of ARF with four weekly administration of benzathine penicillin (BPG) (secondary prophylaxis) in people with known or past ARF/RHD is proven to work and is cost-effective. Evidence suggests that the development and establishment of a systematic and structured approach to improve adherence to secondary prophylaxis is paramount to improve health outcomes. The NT RHD Control Program provides RF and RHD educational and training programs and conducts annual continuous quality improvement (CQI) processes to proactively support health services to develop a systematic structured approach with nominated targets to improve secondary prophylaxis adherence rates and the administration and management of their RHD Program. Analysis of the RHD prevention program has revealed that reduced recurrence rates of ARF have been achieved year by year; however, overall, patients on preventative four weekly LA Bicillin injections only receive 60% of their doses. This paper will discuss issues and new initiatives to improve adherence to secondary prophylaxis. http://dx.doi.org/10.1016/j.hlc.2013.05.603 602 Outcomes of Cardiac Catheterisation Procedures in Indigenous Australians C. Zeitz 1,2, A. Brown3, R. Tavella 1,2, M. Worthley1,4, S. Worthley1,4, D. Chew5, M. Arstall 1, J. Beltrame1,2,∗ 1 The University of Adelaide, Australia 2 The Queen Elizabeth Hospital, Australia 3 South Australian Health and Medical Research Institute, Australia 4 Royal Adelaide Hospital, Australia 5 Flinders Medical Centre, Australia Background: Outcomes following cardiac intervention for Indigenous patients may be less favourable, owing to more extensive disease or higher prevalence of cardiovascular risk factors. Methods: The Coronary Angiogram Database of South Australia (CADOSA) is a comprehensive registry of all public cardiac catheterisation procedures performed in South Australia (SA). Data for 2012 was used to describe baseline characteristics and in hospital events among Indigenous Australians. Results: CADOSA Population Non-Indigenous n= 3587 Indigenous n= 135 (4%) p Age 64± 12 50± 12 <0.01 Female gender 1177 (33%) 68 (50%) <0.01 Current smoker 780 (24%) 69 (57%) <0.01 Hypertension 2341 (65%) 100 (74%) 0.03 Dyslipidaemia 2180 (61%) 96 (71%) <0.01 Dialysis 43 (1%) 20 (15%) <0.01 Angiogram for ACS 1912 (54%) 93 (69%) <0.01 Transferred for procedure 179 (5%) 16 (12%) <0.01 Normal coronaries (<50%) 909 (26%) 36 (27%) 0.37 PCI performed 1363 (38%) 50 (37%) 0.86 Appropriate procedure 2264 (79%) 99 (87%) 0.10 In hospital death 46 (1.3%) 1 (0.8%) 1 Access site complication 52 (1.5%) 2 (1.5%) 1 Bleeding within 72h 89 (2.5%) 2 (1.5%) 0.77 Conclusion: IndigenousAustralians present for angiography nearly 15 years earlier than non-Indigenous Australians. Despite this, they present with greater incidenceof comorbiditiesandaremoreoften transferred.PCI rate and in-hospital complications do not differ; however further evaluation is required with a larger cohort. http://dx.doi.org/10.1016/j.hlc.2013.05.604

Key Factors Influencing Primary Health Service Performance in Prevention Of Recurrent ARF and RHD

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain important causes of illness and premature death among children and young adults in Australian Indigenous populations. Rheumatic fever became a notifiable condition in 1995 in the Northern Territory (NT) and subsequently the NT RHD Register and the NT RHD Control Program was established to provide a website interface data repository to capture a clinical patient reporting system for rheumatic fever episodes. The primary role of the Control Program is to collaboratively and systematically work with primary health care (PHC) services to improve secondary prophylaxis adherence rates. Secondary prevention of ARF with four weekly administration of benzathine penicillin (BPG) (secondary prophylaxis) in people with known or past ARF/RHD is proven to work and is cost-effective. Evidence suggests that the development and establishment of a systematic and structured approach to improve adherence to secondary prophylaxis is paramount to improve health outcomes. The NT RHD Control Program provides RF and RHD educational and training programs and conducts annual continuous quality improvement (CQI) processes to proactively support health services to develop a systematic structured approach with nominated targets to improve secondary prophylaxis adherence rates and the administration and management of their RHD Program. Analysis of the RHD prevention program has revealed that reduced recurrence rates of ARF have been achieved year by year; however, overall, patients on preventative four weekly LA Bicillin injections only receive 60% of their doses. This paper will discuss issues and new initiatives to improve adherence to secondary prophylaxis.

Second Degree Atrioventricular Block Mobitz Type I after Administration of Benzathine Penicillin. Case Report

Second degree atrioventricular block Mobitz type I is seen as a transitory change in the presence of inferior wall myocardial infarction or drug intoxication. The objective of this report was to present a case of second degree atrioventricular block Mobitz type I after administration of benzathine penicillin.The patient had a syncopal episode and sudoresis after administration of benzathine penicillin. On physical exam, he presented diaphoresis, bradycardia, and irregular heart rate. The electrocardiogram (ECG) showed second degree atrioventricular block Mobitz type I. Intravenous atropine, 0.5 mg, was administered. An ECG done one hour later was normal. The patient remained asymptomatic and, and after six hours he was discharged.The patient developed second degree atrioventricular block Mobitz type I after the administration of benzathine penicillin.

Updated guideline for the management of upper respiratory tract infections in South Africa: 2008

Introduction: Inappropriate use of antibiotics for non-severe upper respiratory tract infections (URTIs), many of which are viral, adds to the burden of antibiotic resistance. Antibiotic resistance is increasing in Streptococcus pneumoniae, the microorganism responsible for most cases of acute otitis media (AOM) and acute bacterial sinusitis (ABS). Method: The Infectious Diseases Society of Southern Africa held a multidisciplinary meeting to draw up a national guideline for the management of URTIs in 2003. Background information reviewed included randomised controlled trials, existing URTI guidelines and local antibiotic susceptibility patterns. The initial document was drafted at the meeting. Subsequent drafts were circulated to members of the working group for modification. The guideline was published in the South African Medical Journal in 2004 and was a consensus document based upon the opinions of the working group. In 2008 it was decided to update and republish the guideline. This was done electronically using the same working group members, including overseas experts. Output: Penicillin remains the drug of choice for tonsillopharyngitis. Single-dose parenteral administration of benzathine penicillin is effective, but many favour oral administration twice daily for 10 days. Amoxycillin remains the drug of choice for both AOM and ABS. A dose of 90 mg/kg/day is recommended in general, which should be effective for pneumococci with high-level penicillin resistance (this is particularly likely in children ≤2 years of age, in day-care attendees, in cases with prior AOM within the past six months, and in children who have received antibiotics within the last three months). Alternative antibiotic choices are given in the guideline with recommendations for their specific indications. These antibiotics include amoxycillin-clavulanate, some cephalosporins, the macrolide/azalide and ketolide groups of agents and the respiratory fluoroquinolones. Conclusion: The guideline should assist rational antibiotic prescribing for URTIs. However, it should be continuously updated when new information becomes available from randomised controlled trials and surveillance studies of local antibiotic susceptibility patterns.

Updated guideline for the management of upper respiratory tract infections in South Africa: 2008

Introduction: Inappropriate use of antibiotics for non-severe upper respiratory tract infections (URTIs), many of which are viral, adds to the burden of antibiotic resistance. Antibiotic resistance is increasing in Streptococcus pneumoniae, the microorganism responsible for most cases of acute otitis media (AOM) and acute bacterial sinusitis (ABS). Method: The Infectious Diseases Society of Southern Africa held a multidisciplinary meeting to draw up a national guideline for the management of URTIs in 2003. Background information reviewed included randomised controlled trials, existing URTI guidelines and local antibiotic susceptibility patterns. The initial document was drafted at the meeting. Subsequent drafts were circulated to members of the working group for modification. The guideline was published in the South African Medical Journal in 2004 and was a consensus document based upon the opinions of the working group. In 2008 it was decided to update and republish the guideline. This was done electronically using the same working group members, including overseas experts. Output: Penicillin remains the drug of choice for tonsillopharyngitis. Single-dose parenteral administration of benzathine penicillin is effective, but many favour oral administration twice daily for 10 days. Amoxycillin remains the drug of choice for both AOM and ABS. A dose of 90 mg/kg/day is recommended in general, which should be effective for pneumococci with high-level penicillin resistance (this is particularly likely in children ≤2 years of age, in day-care attendees, in cases with prior AOM within the past six months, and in children who have received antibiotics within the last three months). Alternative antibiotic choices are given in the guideline with recommendations for their specific indications. These antibiotics include amoxycillin-clavulanate, some cephalosporins, the macrolide/azalide and ketolide groups of agents and the respiratory fluoroquinolones. Conclusion: The guideline should assist rational antibiotic prescribing for URTIs. However, it should be continuously updated when new information becomes available from randomised controlled trials and surveillance studies of local antibiotic susceptibility patterns.

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

Benzathine penicillin is the most widely used antibiotic in the prophylaxis of children with rheumatic fever. The aim of the present study was to evaluate the DNA damage in children receiving one dose of 1.2 million units benzathine penicillin every 4 weeks over a long period to prevent recurrences of rheumatic fever. Thirty-five children with confirmed rheumatic fever under benzathine penicillin prophylaxis were enrolled in the study and 35 healthy children with similar ages and socioeconomic backgrounds served as controls. To detect any DNA damage, the comet assay was performed on circulating lymphocytes from the study subjects. Damaged (limited and extensive migration) cells in children on prophylactic therapy were higher than those in controls (P<0.001). It has been suggested that differences in the comet scores were induced by the administration of benzathine penicillin over a long period of time and further investigations are needed to confirm this toxic effect.

Disposition of penicillin G after administration of benzathine penicillin G, or a combination of benzathine penicillin G and procaine penicillin G in cattle

Summary Plasma concentration of penicillin G was evaluated in beef steers after administration of either a combination of benzathine penicillin G and procaine penicillin G in a 1:1 mixture at a dosage of 9,000 U/kg of body weight, im (n = 5), 24,000 U/kg, im (n = 5), or 8,800 U/kg, sc (n = 5), or benzathine penicillin G alone at a dosage of 12,000 U/kg, im (n = 7). Plasma concentration of penicillin G was measured by use of a high-performance liquid chromatography assay that had a limit of determination of 0.005 µg/ml. At a dosage for this combination of 9,000 U/kg im, and 8,800 U/kg, sc, which are approved label recommendations in Canada, and the United States, respectively, mean (± sem) peak plasma concentration was 0.58 (± 0.15) and 0.44 (± 0.02) µg/ml, respectively. Although plasma penicillin concentration was quantifiable for 7 days in the steers that received 9,000 U/kg, im, and for 4 days in the steers that received 8,800 U/kg, sc, the concentration was &lt; 0.1 µg/ml in both groups after the first 12 hours. After administration of the combination at dosage of 24,000 U/kg, im, there was an initial peak plasma concentration at approximately 2 hours; thereafter, plasma concentration decreased slowly, with half-life of 58 hours. Although plasma penicillin G concentration was quantifiable for 12 days at this dosage, concentration was &lt; 0.1 µg/ml after the first 48 hours. After the initial 48 hours, plasma concentration of penicillin was of similar magnitude and decreased at similar rate for the combination at dosage of 24,000 U/kg and for 12,000 U/kg of benzathine penicillin G alone. Most of the plasma penicillin G concentration in the first 24 hours after administration of a 1:1 combination of benzathine penicillin G and procaine penicillin G is attributable to absorption of procaine penicillin G. After the first 48 hours, most of the plasma drug concentration appeared to be produced by absorption of penicillin G from benzathine penicillin G. Absorption of benzathine penicillin G produces quantifiable plasma penicillin G concentrations for several days, but they are below the level of susceptibility for most bacteria.

REACTIONS FROM MULTIPLE INJECTIONS OF BENZATHINE PENICILLIN G

A comparison was made between two dosage plans for the intramuscular administration of benzathine penicillin G as prophylaxis against rheumatic fever, nephritis, and streptococcic infections in the armed forces. One group of 1,567 men received 600,000 units every four weeks; the other group, of 1,708 men, received 900,000 units every six weeks. No reactions of the anaphylactoid type occurred, but during the six months of the study 16 men were hospitalized for urticaria, angioneurotic edema, or joint symptoms; 1 1 were hospitalized after the first injection, 4 after the second, and 1 after the third. Most (11) of these severer reactions occurred after the injection of 900,000 units, but the probability of reaction to subsequent doses decreased in both groups, and prolong the interval between injections did not affect the probability of a reaction. Because few streptococcic infections were seen, this study did not test the effectiveness of the prophylaxis, but it did demonstrate the safety and feasibility of administering benzathine penicillin G in this way.