Factors associated with loss of penicillin G concentrations in serum after intramuscular benzathine penicillin G injection: a meta-analysis

• Published in: The Pediatric infectious disease journal Vol. 31; no. 7; p. 722
• Main Authors: Broderick, Michael P, Hansen, Christian J, Faix, Dennis J
• Format: Journal Article
• Language: English
• Published: United States 01.07.2012
• Subjects: Adult; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - blood; Anti-Bacterial Agents - pharmacokinetics; Antibiotic Prophylaxis - methods; Child; Child, Preschool; Humans; Injections, Intramuscular; Penicillin G Benzathine - administration & dosage; Penicillin G Benzathine - blood; Penicillin G Benzathine - pharmacokinetics; Serum - chemistry; Streptococcal Infections - prevention & control
• ISSN: 1532-0987
• DOI: 10.1097/INF.0b013e31825051d4

An interval of 3-4 weeks between intramuscular injections of 1.2 million units of benzathine penicillin G as prophylaxis against group A streptococcal infection is recommended by health organizations for patients with pediatric rheumatic fever and heart disease. We reviewed the literature for evidence of the persistence of serum penicillin G during the first 4 weeks after the recommended dose of benzathine penicillin G. The weighted-mean concentration was <0.02 µg/mL by 3 weeks after the initial dose. Weighted means were lower in studies done after 1990 than before (P<0.01), in studies dealing with secondary versus primary prophylaxis (P<0.01) and in studies in children versus those in adults (P<0.02). Recommendations for benzathine penicillin G prophylaxis may need reevaluation.