Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1379
2
1
gregorian
2000
5
1
14
1
online
1
fulltext
en
SERUM PENICILLIN LEVEL A FTER INTRAMUSCULA R INJECTION OF 1,200,000 UNITS OF BENZATHINE PENICILLIN G IN CHILDREN WITH RHEUMATIC FEVER
Pediatric
Pediatric
Original Research
Original Research
The most accepted method of secondary prophylaxis in rheumatic fever (RF)
has been an injection of 1,200,000 units of benzathine penicillin G (BPG) every
4 weeks, but recurrences have been reported in some patients despite such a
prophylaxis program. The WHO recommended BPG injections every 3 weeks in
high risk patients and situations due to some published data in favor of inadequacy
of once every 4 weeks injection of BPG.
Our study was designed to determine serum penicillin levels (SPL) during the
4 weeks after an intramuscular injection of 1,200,000 units of BPG, in order to find
the appropriate interval between BPG injections and also to assess the effects of
weight and sex on this level. We included 42 RF patients (mean±SD=14.8±11.9
years) in our study. SPL was determined by disk agar diffusion method. In this
study the minimum accepted SPL to be effective against group A β-hemolytic
streptococci was 0.02 µg/mL. In 46% of the patients the mean SPL decreased to
<0.02 µg/mL at the end of the third week (mean ±SD=2.35 ± 1.3 weeks). The mean
SPLs were significantly higher in patients who weighed <45 kg
(mean±SD=38.6±4.3 kg) in comparison with those who weighed 2:45 kg
(mean±SD=54.25±4.87 kg), with a p value <0.0001. There was no significant
differences in mean SPL between boys and girls (p =0.145). Although in this study
the mean SPL was <0.02 µg/mL in 46% of patients at the end of the third week,
we could not recommend every 3 weeks injections of BPG in all patients, except
in high risk patients and situations as recommended by the WHO and also in those
patients who weighed 2:45 kg.
Rheumatic Fever, Secondary Benzathine Penicillin Prophylaxis, Children, Serum Penicillin Level.
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http://mjiri.iums.ac.ir/browse.php?a_code=A-10-298-348&slc_lang=en&sid=1
MOHAMMAD REZA
SABRI
20031947532846004476
20031947532846004476
Yes
From the Cardiology Units, Pediatric Department, Nemazee Hospital, Shiraz, l.R.lran.
MOHAMMAD RAHIM
KADIVAR
20031947532846004477
20031947532846004477
No
From the lnfectious Disease Units, Pediatric Department, Nemazee Hospital, Shiraz, l.R.lran
MOHAMMAD
BORZOUEE
20031947532846004478
20031947532846004478
No
From the Cardiology Units, Pediatric Department, Nemazee Hospital, Shiraz, l.R.lran.