Frontiers in Pharmacology (Nov 2017)

Fatal and Near-Fatal Non-allergic Reactions in Patients with Underlying Cardiac Disease Receiving Benzathine Penicillin G in Israel and Switzerland

  • Matitiahu Berkovitch,
  • Matitiahu Berkovitch,
  • Liat Ashkenazi-Hoffnung,
  • Liat Ashkenazi-Hoffnung,
  • Ilan Youngster,
  • Ilan Youngster,
  • Dotan Shaniv,
  • Dotan Shaniv,
  • Dorit Dil-Nahlieli,
  • Einat Gorelik,
  • Martina Schäublin,
  • Rudolf Stoller,
  • Nour Karra,
  • Nour Karra,
  • Eyal Schwartzberg,
  • Eyal Schwartzberg

DOI
https://doi.org/10.3389/fphar.2017.00843
Journal volume & issue
Vol. 8

Abstract

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Benzathine Penicillin G (BPG) is commonly used for treatment of penicillin-susceptible infections and secondary prevention of rheumatic fever. Death following administration of BPG is extremely rare—only a handful of cases have been described in the literature since the 1950's. In this case series from Israel and Switzerland, we describe nine cases of serious adverse reactions—six fatal reactions and three near-fatalities—occurring within minutes of receiving intramuscular BPG. Allergic reactions or faulty administration were not implicated in any of the cases; however, all patients had cardiac risk factors. This case series describes a relatively rare risk that should be borne in mind when prescribing BPG.

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