ArticleAnnals of pediatric cardiology
Serum penicillin levels in Indian children and adolescents with rheumatic heart disease receiving benzathine penicillin G prophylaxis.
Article in Annals of pediatric cardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute rheumatic fever and rheumatic heart disease (RHD) are serious complications of untreated Group A Streptococcal infections. Given that India bears the highest global burden of RHD, optimizing secondary prophylaxis is a public health priority. Concerns regarding the adequacy of the current 3-weekly benzathine penicillin G (BPG) regimen and the lack of pharmacokinetic data in Indian children prompted this study. The objective of the study was to quantify serum penicillin levels in Indian children (aged 5-18 years) with RHD receiving 3-weekly BPG prophylaxis. Methods: Children ( Results: The mean age of participants was 12.87 ± 2.1 years; 52.2% were female. Mean serum penicillin concentrations were 5.21 ± 6.41 ng/mL (day 0), 22.16 ± 22.62 ng/mL (day 2), 20.22 ± 18.11 ng/mL (day 6), and 10.15 ± 7.26 ng/mL (day 14). Levels were significantly higher at all postinjection time points compared to baseline ( Conclusions: Most Indian children receiving 3-weekly BPG prophylaxis for RHD do not maintain therapeutic serum penicillin concentrations for >1 week postinjection. These findings highlight the limitations of the current prophylaxis strategy and underscore the need to reassess injection intervals.
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