Content area
Full Text
About the Authors:
Michael P. Broderick
Contributed equally to this work with: Michael P. Broderick, Edward L. Kaplan, Dennis J. Faix
* E-mail: [email protected]
Affiliation: Henry M. Jackson Foundation for the Advancement of Military Medicine, Naval Health Research Center, San Diego, California, United States of America
Christian J. Hansen
Affiliation: Henry M. Jackson Foundation for the Advancement of Military Medicine, Naval Health Research Center, San Diego, California, United States of America
Kevin L. Russell
Affiliations Naval Health Research Center, San Diego, California, United States of America, United States Department of Defense Global Emerging Infections Surveillance and Response System, Silver Spring, Maryland, United States of America
Edward L. Kaplan
Contributed equally to this work with: Michael P. Broderick, Edward L. Kaplan, Dennis J. Faix
Affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
Jeffrey L. Blumer
Current address: The University of Toledo, College of Medicine and Life Sciences, Toledo, Ohio, United States of America
Affiliation: Departments of Pediatrics and Pharmacology, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States of America
Dennis J. Faix
Contributed equally to this work with: Michael P. Broderick, Edward L. Kaplan, Dennis J. Faix
Affiliation: Naval Health Research Center, San Diego, California, United States of America
Introduction
Benzathine penicillin G (BPG) has been a mainstay of treatment and prophylaxis against group A beta-hemolytic streptococcus (GAS) since its clinical introduction in the early 1950s [1]. Studies by Rusoff and Stollerman [2] demonstrated that this repository form of penicillin provided adequate serum levels for both treatment of GAS as well as for prevention of acquisition of group A streptococci for 3 weeks or longer following injection at recommended BPG doses.
BPG remains an integral part of most recommendations/guidelines for management of GAS upper respiratory tract infections [3], [4], [5]. Its primary advantages include improved compliance over oral preparations, and improved effectiveness even when compliance has been documented [6]. It has proved effective in both endemic and epidemic GAS disease, especially in military populations where streptococcal infections have historically been and remain significant medical and public health problems.
Recently, unexpectedly high streptococcal treatment failure rates were reported when treating streptococcal pharyngitis with BPG [6]. The duration of adequate serum penicillin levels for GAS is dose-dependent; the...