Evidence map›Paper›PMID 31297163›Full record

ArticleHeart Asia2019

Severe adverse events following benzathine penicillin G injection for rheumatic heart disease prophylaxis: cardiac compromise more likely than anaphylaxis.

Shannon Marantelli, Robert Hand, Jonathan Carapetis, Andrea Beaton, Rosemary Wyber

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Heart Asia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
2.9field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Acute rheumatic fever and rheumatic heart disease.Nature reviews. Disease primers · 2026
    Review
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  13. The "Cairo Accord"- Towards the Eradication of RHD: An Update.Frontiers in cardiovascular medicine · 2021
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 3 countries.

Shannon MarantelliSchool of Medicine, University of Western Australia, Perth, Western Australia, Australia.ORCID 0000-0003-1944-0607
Robert HandTelethon Kids Institute, University of Western Australia, Subiaco, Western Australia, Australia.
Jonathan CarapetisTelethon Kids Institute, University of Western Australia, Subiaco, Western Australia, Australia.
Andrea BeatonDepartment of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Rosemary WyberTelethon Kids Institute, University of Western Australia, Subiaco, Western Australia, Australia.
The Kids Research Institute Australia · AUCincinnati Children's Hospital Medical Center · USThe University of Western Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSecondary prophylaxis through long-term antibiotic administration is essential to prevent the progression of acute rheumatic fever to rheumatic heart disease (RHD). Benzathine penicillin G (BPG) has been shown to be the most efficacious antibiotic for this purpose; however, adverse events associated with BPG administration have been anecdotally reported. This study therefore aimed to collate case reports of adverse events associated with BPG administration for RHD prophylaxis. STUDY

designA literature review was used to explore reported adverse reactions to BPG and inform development of a case report questionnaire. This questionnaire was circulated through professional networks to solicit retrospective reports of adverse events from treating physicians. Returned surveys were tabulated and thematically analysed. Reactions were assessed using the Brighton Collaboration case definition to identity potential anaphylaxis.

resultsWe obtained 10 case reports from various locations, with patients ranging in age from early-teens to adults. All patients had clinical or echocardiogram-obtained evidence of valvular disease. The majority of patients (80%) had received BPG prior to the event with no previous adverse reaction. In eight cases, the reaction was fatal; in one case resuscitation was successful and in one case treatment was not required. Only three cases met Level 1 Brighton criteria consistent with anaphylaxis.

conclusionThese results indicate that anaphylaxis is not a major cause of adverse reactions to BPG. An alternative mechanism for sudden death following BPG administration in people with severe RHD is proposed.

Indexed as

acute rheumatic feveradverse eventanaphylaxisbenzathine penicillin gBPGcase seriesrheumatic heart disease

Identifiers

PMID31297163
PMCPMC6590992
OpenAlexW2950800920

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.