ArticleAntimicrobial agents and chemotherapy2023
Subcutaneous infusion of high-dose benzathine penicillin G is safe, tolerable, and suitable for less-frequent dosing for rheumatic heart disease secondary prophylaxis: a phase 1 open-label population pharmacokinetic study.
Article in Antimicrobial agents and chemotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Patient preferences for prophylactic regimens requiring regular injections in children and adolescents: a systematic review and thematic analysis.BMJ paediatrics open · 2024Pooled it
- Trial
- Trial
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- Key Considerations in Evaluating Syphilis Therapeutics.Sexually transmitted diseases · 2026Article
- When and How to Use Subcutaneous Antibiotics.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Review
- Acute rheumatic fever and rheumatic heart disease.Nature reviews. Disease primers · 2026Review
- Review
- Stakeholders Want a Menu of Choices: Findings from a Consultation Workshop on Improving Access to Secondary Prophylaxis of Rheumatic Fever and Rheumatic Heart Disease.Global heart · 2026Article
- Toward adaptive therapeutic timing: integration of mechanistic pharmacology and artificial intelligence in precision dosing.Frontiers in pharmacology · 2026Review
- The "Cairo Accord"- towards the eradication of RHD: revisited (2026).Frontiers in cardiovascular medicine · 2026Review
- Article
- Scoping review of variation in clinical guidelines for delivery of injectable long-acting penicillin across Australia and Aotearoa New Zealand.The Medical journal of Australia · 2025Article
- Prevention of rheumatic heart disease in New Zealand: High-dose subcutaneous benzathine penicillin is cost-saving compared with traditional intramuscular injections.IJID regions · 2025Article
- Shortages of benzathine benzylpenicillin G in Australia highlight the need for new sovereign manufacturing capability.The Medical journal of Australia · 2025Article
- Subcutaneous injections of penicillin (SCIP): Convenient and effective treatment for Māori, Pacific Peoples and their families in preventing rheumatic heart disease.PLOS global public health · 2025Article
- Acceptability and Implementation Challenges of Benzathine Penicillin G Secondary Prophylaxis for Rheumatic Heart Disease in Ethiopia: A Qualitative Study.Global heart · 2025Article
- Article
- Local anaesthetic to reduce injection pain in patients who are prescribed intramuscular benzathine penicillin G: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Intramuscular versus enteral penicillin prophylaxis to prevent progression of rheumatic heart disease: Study protocol for a noninferiority randomized trial (the GOALIE trial).American heart journal · 2024Article
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Authors and funding
14 authors at 6 institutions in 2 countries.
Funding
Abstract
Since 1955, the recommended strategy for rheumatic heart disease (RHD) secondary prophylaxis has been benzathine penicillin G [BPG; 1.2 MU (900 mg)] injections administered intramuscularly every 4 weeks. Due to dosing frequency, pain, and programmatic challenges, adherence is suboptimal. It has previously been demonstrated that BPG delivered subcutaneously at a standard dose is safe and tolerable and has favorable pharmacokinetics, setting the scene for improved regimens with less frequent administration. The safety, tolerability, and pharmacokinetics of subcutaneous infusions of high-dose BPG were assessed in 24 healthy adult volunteers assigned to receive either 3.6, 7.2, or 10.8 MU (three, six, and nine times the standard dose, respectively) as a single subcutaneous infusion. The delivery of the BPG to the subcutaneous tissue was confirmed with ultrasonography. Safety assessments, pain scores, and penicillin concentrations were measured for 16 weeks post-dose. Subcutaneous infusion of penicillin (SCIP) was generally well tolerated with all participants experiencing transient, mild infusion-site reactions. Prolonged elevated penicillin concentrations were described using a combined zero-order (44 days) and first-order (
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