Four-Weekly Benzathine Penicillin G Provides Inadequate Protection against Acute Rheumatic Fever in Some Children.

Abstract

This study aimed to identify recurrent acute rheumatic fever (ARF) episodes which occurred despite adherence to prophylactic benzathine penicillin G (BPG). Data from Australia's Northern Territory were analyzed; ARF recurrences between 2012 and 2017 diagnosed while the person was prescribed BPG were identified. Days at risk (DAR)-median and interquartile range-preceding ARF onset were calculated. The timing of BPG doses was examined for individuals with no DAR. One hundred sixty-nine ARF recurrences were analyzed; median DAR in the previous 8 weeks before ARF onset was 29. Most recurrences occurred following > 7 DAR (87%). Eight recurrences (5%) occurred despite no DAR; all were aged less than 16 years at the time of their recurrence/s. Recurrent ARF most commonly occurs after delayed BPG doses, but in some cases, receiving every prescribed BPG dose on time did not prevent recurrent ARF. A method to identify high-risk individuals before recurrent ARF is needed.

• Authors: Jessica L de Dassel, Halla Malik, Anna P Ralph, Kate Hardie, Boglarka Remenyi, Joshua R Francis
• Journal: The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 100 Issue 5 Pg. 1118-1120 (05 2019) ISSN: 1476-1645 [Electronic] United States
• PMID: 30915960 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Penicillin G Benzathine

Topics

• Adolescent
• Adult
• Anti-Bacterial Agents (administration & dosage)
• Child
• Child, Preschool
• Drug Administration Schedule
• Female
• Humans
• Male
• Middle Aged
• Northern Territory
• Penicillin G Benzathine (administration & dosage)
• Recurrence
• Rheumatic Fever (microbiology, prevention & control)
• Streptococcal Infections (prevention & control)
• Treatment Failure
• Young Adult