Preliminary consultation on preferred product characteristics of benzathine penicillin G for secondary prophylaxis of rheumatic fever

Rosemary Wyber; Ben J Boyd; Samantha Colquhoun; Bart J Currie; Mark Engel; Joseph Kado; Ganesan Karthikeyan; Mark Sullivan; Anita Saxena; Meru Sheel; Andrew Steer; Joseph Mucumbitsi; Liesl Zühlke; Jonathan Carapetis

doi:10.1007/s13346-016-0313-z

Preliminary consultation on preferred product characteristics of benzathine penicillin G for secondary prophylaxis of rheumatic fever

Drug Deliv Transl Res. 2016 Oct;6(5):572-8. doi: 10.1007/s13346-016-0313-z.

Authors

Rosemary Wyber¹, Ben J Boyd², Samantha Colquhoun³, Bart J Currie^{4

5}, Mark Engel⁶, Joseph Kado⁷, Ganesan Karthikeyan⁸, Mark Sullivan⁹, Anita Saxena⁸, Meru Sheel¹⁰, Andrew Steer¹¹, Joseph Mucumbitsi¹², Liesl Zühlke¹³, Jonathan Carapetis^{10

14}

Affiliations

¹ Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Western Australia, 6008, Australia. Rosemary.Wyber@telethonkids.org.au.
² Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), Parkville, Australia.
³ Murdoch Childrens Research Institute, University of Melbourne, Parkville, Australia.
⁴ Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
⁵ Royal Darwin Hospital, Darwin, Australia.
⁶ Department of Medicine, University of Cape Town, Cape Town, South Africa.
⁷ College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
⁸ Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
⁹ Medicines Development for Global Health, Melbourne, Australia.
¹⁰ Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Western Australia, 6008, Australia.
¹¹ Group A Streptococcal Research Group, Murdoch Children's Research, University of Melbourne, Melbourne, Australia.
¹² Department of Paediatrics, King Faisal Hospital, Kigali, Rwanda.
¹³ Department of Paediatric Cardiology, University of Cape Town, Cape Town, South Africa.
¹⁴ Princess Margaret Hospital for Children, Perth, Western Australia, Australia.

PMID: 27465618
DOI: 10.1007/s13346-016-0313-z

Abstract

Rheumatic fever is caused by an abnormal immune reaction to group A streptococcal infection. Secondary prophylaxis with antibiotics is recommended for people after their initial episode of rheumatic fever to prevent recurrent group A streptococcal infections, recurrences of rheumatic fever and progression to rheumatic heart disease. This secondary prophylaxis must be maintained for at least a decade after the last episode of rheumatic fever. Benzathine penicillin G is the first line antibiotic for secondary prophylaxis, delivered intramuscularly every 2 to 4 weeks. However, adherence to recommended secondary prophylaxis regimens is a global challenge. This paper outlines a consultation with global experts in rheumatic heart disease on the characteristics of benzathine penicillin G formulations which could be changed to improve adherence with secondary prophylaxis. Characteristics included dose interval, pain, administration mechanism, cold chain independence and cost. A sample target product profile for reformulated benzathine penicillin G is presented.

Keywords: Benzathine; Fever; Heart; Penicillin; Prophylaxis; Rheumatic.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Attitude of Health Personnel*
Drug Compounding
Drug Delivery Systems*
Humans
Penicillin G Benzathine / administration & dosage*
Penicillin G Benzathine / therapeutic use*
Rheumatic Fever / prevention & control*
Secondary Prevention / methods*

Substances

Penicillin G Benzathine