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Inadvertent use of Bicillin C-R for treatment of syphilis--Maryland, 1998.

Abstract
In October 1998, the Maryland Department of Health and Mental Hygiene (MDH) was notified that a public sexually transmitted disease (STD) clinic in a county (county A) had used a nonrecommended preparation to treat syphilis patients during January-October 1998. The clinic had been inadequately treating syphilis patients or syphilis contacts with Bicillin C-R (a mixture of 1.2 million units [MU] benzathine penicillin G [BPG] and 1.2 MU procaine penicillin G), rather than with Bicillin L-A (2.4 MU BPG). Compared with short-acting procaine penicillin G, BPG has a longer half-life considered essential for effective syphilis treatment because it yields sustained spirochetecidal levels needed to treat the slowly reproducing agent of syphilis, Treponema pallidum. The inadvertent use of Bicillin C-R, which contains only half the recommended dose of BPG for syphilis, was recognized by a health-care provider at the STD clinic in a neighboring county (county B) approximately 1 month after county B had borrowed BPG from county A. This report summarizes the investigation of the use of Bicillin C-R to treat STD patients in county A and discusses the frequency of Bicillin C-R use in STD clinics nationwide. Findings of this investigation indicate that inadvertent Bicillin C-R use is more frequent than previously known and that preventive measures should be taken to minimize such use.
AuthorsCenters for Disease Control and Prevention (CDC)
JournalMMWR. Morbidity and mortality weekly report (MMWR Morb Mortal Wkly Rep) Vol. 48 Issue 35 Pg. 777-9 (Sep 10 1999) ISSN: 0149-2195 [Print] United States
PMID11263547 (Publication Type: Journal Article)
Chemical References
  • Penicillins
  • Penicillin G Benzathine
Topics
  • Community Health Services
  • Humans
  • Maryland
  • Penicillin G Benzathine (therapeutic use)
  • Penicillins (therapeutic use)
  • Syphilis (drug therapy)
  • Treatment Failure

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