Comparison of minimal inhibitory and bactericidal capacity of oral penicillin V with benzathine penicillin G to Streptococcus beta--hemolyticus group A in children with rheumatic heart disease

Abstract

Background Injection ofbenzatine penicillin G (BPG) every 28 days is still the drug of choice for secondary prevention of rheu- matic heart disease (RHD). BPG sometimes poses problems due to pain at the injection site, possible anaphylaxis, and is not always available. Some centers choose oral penicillin over BPG. Objectives To compare minimal inhibitory capacity (MIC) and minimal bactericidal capacity (MBC) of oral penicillin V serum with those of BPG among SGA infected RHD. Methods This was a clinical trial with crossover design study to compare MIC of penicillin V and BPG. Outcome measures were MIC and MBC. Statistical analysis was performed using paired t-test and wilcoxon test. Result There were 32 subjects consisted of 17 males and 15 females. The mean value of MIC and MBC serum of penicillin V were 0.031 and 0.125. The mean value of MIC and MBC serum of BPG3 were 0.094 and 0.031. Respectively the MIC of penicillin V was similar to that of BPGy The mean value of MIC and MBC of BPG4 were 0.125 and 0.250. Respectively the MIC of penicillin V was significantly higher than that of BPG 4. The MBC of penicillin V was significantly higher than that of BPG 4. The MIC ofBPG 3 was similar to that ofBPG 4• The MBC of BPG 3 was similar to that of BPG 4. Conclusions The MIC of penicillin V was similar to that ofBPG 3, the MBC of oral penicillin V was higher than that ofBPG 3• The MIC and MBC of penicillin V was higher than those of BPG 4.

Keywords

• bactericidal
• oral penicillin V and benzathine penicillin G
• Streptococcus beta- hemolyticus group A