Benzathine Penicillin for Recurrence of Rheumatic Fever: The Jury Is Still Out

SERUM PENICILLIN LEVEL A FTER INTRAMUSCULA R INJECTION OF 1,200,000 UNITS OF BENZATHINE PENICILLIN G IN CHILDREN WITH RHEUMATIC FEVER

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 on...

Confirmed penicillin allergy among patients receiving benzathine penicillin prophylaxis for acute rheumatic fever.

BACKGROUND Beta-lactam antibiotics are the most frequent drugs prescribed in children worldwide. Acute rheumatic fever (ARF) is the major cause of acquired heart disease among children and adolescents. Recurrences due to inadequate penicillin prophylaxis are responsible for chronic valvular lesions requiring surgery. The fear of a severe allergic reaction is the leading cause of discontinuing p...

Splinting poststroke: the jury is still out.

Splinting Poststroke: the Jury Is Still Out To the Editor: In the article abstract by Lannin et al,1 the authors claim “the practice of routine splinting soon after stroke should be discontinued.” Their presented data does not show this. The stated aim was to determine the effect of splinting “on contracture in the wrist and long finger flexor muscles”1 without defining ‘contracture’. Participa...

Are monarch butterflies true navigators? The jury is still out.

Long-term prognosis of rheumatic fever patients receiving regular intramuscular benzathine penicillin.

The prognosis for 115 rheumatic fever patients subsequently receiving regular intramuscular penicillin prophylaxis for at least 5 years was studied. Average follow-up was 9.3 years, and 57 patients were followed for 10 years or longer. Of the 79 patients with acute mitral regurgitation, 70% lost their murmur from 4 days to 8.5 years after it was first heard. This is in contrast to those with ac...