Two case reports and a review of the literature will be presented to alert clinicians to this reaction. Suggestions for management will also be offered. [ncbi.nlm.nih.gov]

• Fever

  BACKGROUND: Benzathine penicillin G every 3 weeks is the standard protocol for secondary prophylaxis for recurrent rheumatic fever. [ncbi.nlm.nih.gov]

• Pain

  Serum penicillin concentrations and subjective pain sensation were determined after each injection. [ncbi.nlm.nih.gov]

  pain; pounding in the chest; rapid breathing; seizures; severe diarrhea; stomach pain/cramps; vaginal irritation or itching; worsening of skin lesions. [indiamart.com]

• Streptococcal Infection

  Abstract Rheumatic fever is caused by an abnormal immune reaction to group A streptococcal infection. [ncbi.nlm.nih.gov]

  In patients who took the oral medication regularly, the incidence of streptococcal infections, as determined by a significant rise in antistreptolysin O titer, was the same as in those who received penicillin intramuscularly. [pediatrics.aappublications.org]

  Penicillin G benzathine is indicated in the treatment of infections that are susceptible to low and prolonged serum levels: upper respiratory tract streptococcal infection, syphilis, yaws, and prevention of rheumatic fever. [onlinelibrary.wiley.com]

• Intravenous Administration

  We report a child with a 6-year history of linear morphea in whom intravenous administration of 5 MU aqueous penicillin G three times a day for 10 consecutive days caused reduction in the thickness of the corium as demonstrated by ultrasound measurements [ncbi.nlm.nih.gov]

  Pain and sterile inflammation can occur at the site of intramuscular injection; phlebitis or thrombophlebitis sometimes follows intravenous administration of benzylpenicillin. [apps.who.int]

  • Inadvertent administration by the intravenous route has been associated with cardiorespiratory arrest and death. • Fatal reactions to BPG have been rarely reported since the 1950's. [frontiersin.org]

  THERE HAVE BEEN REPORTS OF INADVERTENT INTRAVENOUS ADMINISTRATION OF PENICILLIN G BENZATHINE, WHICH HAS BEEN ASSOCIATED WITH CARDIORESPIRATORY ARREST AND DEATH. [rxwiki.com]

  administration, which has been associated with cardiorespiratory arrest and death reported; do not inject drug intravenously or admix with other intravenous solutions Prior to administration, carefully read the warnings, adverse reactions, and dosage [reference.medscape.com]

• Severe Pain

  Oxycodone Oxycodone is indicated for the treatment of moderate to severe pain.[Label] There is also an extended release formulation indicated for chronic moderate to severe pain requiring continuous opioid analgesics for... [drugbank.ca]

  Get medical help right away if you have any very serious side effects, including: pain/redness/swelling/numbness/weakness of arms/legs, change in skin color near the injection site or on arms/legs, severe pain/peeling skin at the injection site, muscle [webmd.com]

  Accidental injection into a peripheral nerve causes severe pain and dysfunction. [apps.who.int]

  Tell your doctor right away if you have: pain, numbness, tingling, burning, or feeling cold; pale or mottled skin, blue-colored lips, fingers, or toes; severe pain, tingling, weakness, or swelling in your lower leg; weakness in your arms or legs; or blistering [umcvc.org]

• Pneumonia

  Abstract Although widely endorsed for specific treatment of pneumococcal pneumonia, penicillin G is seldom used for this purpose in clinical practice for at least three reasons: (1) concern about penicillin-resistant Streptococcus pneumoniae (PRSP) strains [ncbi.nlm.nih.gov]

• Constipation

  Side Effects Nausea, constipation, diarrhea, headache, or trouble sleeping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. [webmd.com]

• Arthritis

  Dosage forms: INJ infections, bacterial [neonates] Dose: 50,000-100,000 units/kg/day IM/IV divided q6-12h; Info: for cellulitis, impetigo, erysipelas, septic arthritis, osteomyelitis; dose, duration vary by infection type, severity [infants/children] [online.epocrates.com]

  Indication Arthritis, gastrointestinal and respiratory infections caused by oxytetracycline sensitive micro-organisms, like Bordetella, Campylobacter, Chlamydia, E. coli, Haemophilus, Mycoplasma, Pasteurella, Rickettsia, Salmonella, Staphylococcus and [alibaba.com]

  […] aqueous penicillin G recommended for streptococcal bacteremia Moderate/severe respiratory tracts infection caused by pneumococci (use aqueous penicillin G for acute stage of severe pneumonia, empyema, bacteremia, pericarditis, meningitis, peritonitis, or arthritis [reference.medscape.com]

  Uses: For the treatment of Haverhill fever with endocarditis due to S moniliformis; for the treatment of rat-bite fever due to S minus or S moniliformis Usual Pediatric Dose for Lyme Disease - Arthritis AAN and IDSA Recommendations: Children: 200,000 [drugs.com]

  Gonorrheal endocarditis and arthritis: minimum 5million Units per day. Meningococcal meningitis: 1–2million Units IM every 2 hours, or continuous IV drip of 20–30million Units/day. [empr.com]

• Skin Rash

  Adverse effects Hypersensitivity reactions range in severity from skin rashes to immediate anaphylaxis. [apps.who.int]

  Skin: Itchy palms or axilla, pruritus, urticaria, flushed skin, delayed skin rashes ranging from urticaria to exfoliative dermatitis, Stevens-Johnson syndrome, fixed-drug eruptions, contact dermatitis. [robholland.com]

  Even though only small amounts may pass into breast milk, allergic reactions, diarrhea, fungus infections, and skin rash may occur in nursing babies. [drugs.com]

  Side effects that you should report to your doctor or health care professional as soon as possible: allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue breathing problems dark urine fever with headache, flushing [my.clevelandclinic.org]

• Urticaria

  [Ref] Dermatologic Dermatologic side effects have included rash and urticaria. Contact dermatitis has been reported in those who prepared penicillin solutions. [drugs.com]

  Skin: Itchy palms or axilla, pruritus, urticaria, flushed skin, delayed skin rashes ranging from urticaria to exfoliative dermatitis, Stevens-Johnson syndrome, fixed-drug eruptions, contact dermatitis. [robholland.com]

  A serum sickness-like reaction has been reported, characterized by fever, malaise, urticaria, arthralgia, myalgia, lymphadenopathy and splenomegaly. [rxmed.com]

  Typical allergic symptoms like urticaria or angioedema were missing in all cases. Three patients recovered, while in six cases the outcome was fatal despite intense resuscitation efforts. [frontiersin.org]

  Another type of immediate reaction, an accelerated reaction, may occur between 20 minutes and 45 hours after administration and may include urticaria, pruritus, fever and, occasionally, laryngeal edema. [wikidoc.org]

• Blister

  Penicillins Product List Product Name Trade Name Dosage Pharmaceutical Form/presentation AMOXICILLIN AND CLAVULANIC ACID TBT AMOXICILLINA E ACIDO CLAVULANICO BIOPHARMA 875 mg + 125 mg 12 tablets in blister AMOXICILLIN AND CLAVULANIC ACID SACHETS AMOXICILLINA [orofinopharma.com]

  It is important to allow the cartridge blister pack to reach room temperature before exposing the discs, a period of one hour is generally sufficient. [oxoid.com]

  According to numerous preliminary reports, niacinamide, given in combination with tetracycline or minocycline, may be effective against bullous pemphigoid, a benign, autoimmune blistering disease of the skin. [peacehealth.org]

  Signs of a very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in the mouth, throat, nose, or eyes. [drugs.com]

  […] sudden and progressing nausea nosebleeds pale skin pinpoint red spots on the skin puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue seeing or hearing things that are not there seizures sensation of pins and needles skin blisters [mayoclinic.org]

• Eczema

  In individuals predisposed to develop allergic disease(s), the sequence of sensitization and clinical manifestations proceed as follows: eczema and respiratory disease (rhinitis and bronchospasm) in infants and children less than 5 years due to food sensitivity [mayomedicallaboratories.com]

  History of or suspected allergy (asthma, eczema, hay fever, hives); history of allergy to cephalosporins; kidney or liver dysfunction, myasthenia gravis, epilepsy, neonates, young infants. Use during lactation may lead to sensitization of infants. [robholland.com]

  Make sure you tell your doctor if you have any other medical problems, especially: Allergy, general (such as asthma, eczema, hay fever, hives), history of—Patients with a history of general allergies may be more likely to have a severe reaction to penicillins [drugs.com]

  Make sure you tell your doctor if you have any other medical problems, especially: Allergy, general (such as asthma, eczema, hay fever, hives ), history of—Patients with a history of general allergies may be more likely to have a severe reaction to penicillins [goodrx.com]

• Seizure

  Gram negative cocci Spirochaetes Prophylaxis: endocarditis orthopaedics surgery post splenectomy CONTRAINDICATIONS hypersensitivity resistant organism high dose in renal dysfunction ADVERSE EFFECTS superinfection (pseudomembranous colitis) GI upset seizures [lifeinthefastlane.com]

  Psychosis and/or seizures following the administration of intramuscular penicillin G procaine have not been reported in the pediatric literature to our knowledge. [ncbi.nlm.nih.gov]

  CSF penicillin levels ranged from 12 to 61 units/mL in the seizure group with the highest CSF concentrations, compared to 7.8 units/mL in the group without seizures. [drugs.com]

  If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. [nlm.nih.gov]

• Meningism

  The usual dose recommendations are as follows: Adult patients *Because of its short half-life, Penicillin G is administered in divided doses,usually every 4-6 hours with the exception of meningococcal meningitis/septicemia, i.e., every 2 hours. [globalrph.com]

  Usual Adult Dose for Meningitis - Meningococcal 24 million units/day, administered as 2 million units IV every 2 hours Use: For the treatment of meningococcal meningitis and/or septicemia due to Neisseria meningitidis IDSA Recommendations: 24 million [drugs.com]

  Adults with meningitis: 15–20million Units/day for 2 weeks. Adults with endocarditis: 15–20million Units/day for 4 weeks. Pasteurella infections: Bacteremia and meningitis: 4–6million Units/day for 2 weeks. [empr.com]

  [neonates] Dose: 100,000-200,000 units/kg/day IM/IV divided q6-12h [infants/children] Dose: 250,000-400,000 units/kg/day IM/IV divided q4-6h; Max: 24 million units/day meningitis, Group B Strep [neonates] Dose: 250,000-450,000 units/kg/day IM/IV divided [online.epocrates.com]

  Benzylpenicillin (INN, AAN, BAN), also known as penicillin G (USAN), is a narrow spectrum penicillin antibiotic that is given intravenously or intramuscularly as a treatment for syphilis, meningitis, endocarditis, pneumonia, lung abscesses and septicaemia [dbpedia.org]

• Confusion

  – Pregnancy: no contra-indication – Breast-feeding: no contra-indication – Do not confuse short-acting benzylpenicillin, administered several times a day by IV route, with long-acting penicillins (benzathine benzylpenicillin and procaine benzylpenicillin [medicalguidelines.msf.org]

  Overdose symptoms may include confusion, agitation, hallucinations, or seizure (convulsions). What should I avoid while taking penicillin G sodium? Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. [drugs.com]

  Severe allergic reactions ; agitation; bizarre behavior; blood in urine; bloody stools; chest pain; chills; confusion; extreme tiredness; fainting; fast heartbeat; fever; flushing with lightheadedness or fainting; hallucinations; headache; itching; muscle [indiamart.com]

  […] fast/slow/irregular heartbeat, new signs of infection (e.g., fever, persistent sore throat), easy bruising/bleeding, signs of kidney problems (such as change in the amount of urine), numbness/tingling of arms/legs, seizures, uncontrolled movements, confusion [webmd.com]

• Headache

  Side effects that you should report to your doctor or health care professional as soon as possible: allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue breathing problems dark urine fever with headache, flushing [my.clevelandclinic.org]

  Signs and symptoms of strep throat include headache, nausea, vomiting, sore... Meningococcemia Meningococcemia is a bloodstream infection caused by Neisseria meningitides. Meningococcemia symptoms include fever, headache,... [medicinenet.com]

  Headache. A fast heartbeat. Fast breathing. Flushing. Yellow skin or eyes. Muscle or joint pain. Stomach pain. Twitching. Seizures. Not able to pass urine or change in how much urine is passed. Diarrhea is common with antibiotics. [drugs.com]

  • Know that in syphilis treatment, Jarisch-Hersheimer reaction (fever, chills, headache, sweating, malaise, hypotension or hypertension) may occur 2 to 12 hours after therapy begins and usually subsides within 24 hours. [medical-dictionary.thefreedictionary.com]

• Myoclonus

  Severe reactions (including myoclonus, seizures, auditory and visual hallucinations, and decreased mentation) have been reported with high dose penicillin therapy or in patients with renal dysfunction. [drugs.com]

  SLE-like syndrome, Injection site reactions (pain, inflammation, abscess, phlebitis), superinfections (especially with Candida and gram-negative bacteria), neuromuscular irritability (twitching, lethargy, confusion, stupor, hyperreflexia, multifocal myoclonus [robholland.com]

  The manifestations may include agitation, confusion, asterixis, hallucinations, stupor, coma, multifocal myoclonus, seizures and encephalopathy. Hyperkalemia is also possible (see Adverse Reactions -Metabolic). [web.archive.org]

For each subject, the leukocyte count, platelet count, and blood and superficial specimen cultures were performed as part of the routine workup. Pharmacokinetics study. The pharmacokinetics of penicillin G were studied on day 3 of life. [aac.asm.org]

• Neisseria Gonorrhoeae

  Other organisms sensitive in-vitro to penicillin G are Neisseria gonorrhoeae, Bacillus anthracis, Corynebacterium diphtheriae, Clostridia et al. Treponema pallidum is extremely sensitive [1]. [apexbt.com]

  Main indications Community acquired pneumonia Cellulitis Streptococcal endocarditis Other serious streptococcal infections Active against most strains of: Streptococci (Group A, B, C, G, viridans, pneumoniae, milleri) Neisseria meningitidis Neisseria [gloshospitals.nhs.uk]

  Penicillinase-producing Neisseria gonorrhoeae. Lancet 2: 657–658 (1976). PubMed CrossRef Google Scholar Baldwin, D.S.; Levine, B.B.; McCluskey, R.T. and Gallo, G.R.: Renal failure and interstitial nephritis due to penicillin and methicillin. [link.springer.com]

  AMP, METH 61 1981 Effect of penicillin G on release of peptidoglycan fragments by Neisseria gonorrhoeae: characterization of extracellular products. PG 62 1981 Skin testing to detect penicillin allergy. [allie.dbcls.jp]

Abstract Doxycycline is the preferred recommended second-line treatment for the treatment of early syphilis. Recent reports showed a declining efficacy trend of doxycycline in treatment of early syphilis. [ncbi.nlm.nih.gov]

Valvular sequelae is the most dreadful consequence of acute rheumatic fever, and such cardiac lesions can also predispose a patient to infective endocarditis (IE), a morbid disease that worsens the prognosis of these patients1-4. [scielo.br]

Regarding the etiology of pneumonia based on the final results of microbial investigation, 46 cases (65.7%) were Streptococcus pneumoniae, and 17 (24.3%) were of an undetermined etiology. [bmcresnotes.biomedcentral.com]

[…] treatment of pneumococcal pneumonia, penicillin G is seldom used for this purpose in clinical practice for at least three reasons: (1) concern about penicillin-resistant Streptococcus pneumoniae (PRSP) strains; (2) the difficulty of making an early etiologic [ncbi.nlm.nih.gov]

Página 330 - Intestinal infections in patients with the acquired immunodeficiency syndrome (AIDS): etiology and response to therapy. ‎ [books.google.es]

Interpretation Provides information to assist in interpretation of the test results Detection of IgE antibodies in serum (Class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens [mayomedicallaboratories.com]

This is evidence of the lack of BPG influence on the most prevalent microorganism in the bacterial plaque and one of the main Infectious Endocarditis etiological agents20,21,26. [scielo.br]

Category Pharmacology Penicillin antibiotic as 0.6 MIU, 1.2 MIU and 2.4 MIU powder and solvent for suspension for injection Epidemiology There were 5,288 new diagnoses of syphilis in England in 2015, a 19.9% increase from 4,412 in 2014. [sps.nhs.uk]

This investigation was conducted under the sponsorship of the Commission on Streptococcal Diseases, Armed Forces Epidemiological Board. It was supported by the Office of the Surgeon General, departments of the Army and Air Force, Washington, D. [nejm.org]

Washington, DC American Society for Microbiology (pg. 739 - 45 ) 16 Epidemiological section, Khon Kaen Provincial Health Office ., Annual epidemiological surveillance report, Khon Kaen province, 2000 Khon Kaen Khon Kaen Hospital pg. 112 17 Computer and [academic.oup.com]

In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. DOSAGE AND ADMINISTRATION Penicillin G potassium may be given intravenously or intramuscularly. [druglib.com]

Página 302 - Groszmann RJ, Atterbury CE: The pathophysiology of portal hypertension: a basis for classification. Semin Liver Dis 1982; 2:177. ‎ [books.google.es]

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Clinical manifestations of immediate hypersensitivity (allergic) diseases are caused by the release of proinflammatory mediators [mayomedicallaboratories.com]

The most likely pathophysiologic explanation for these fatalities is that the BPG compound is a crystalline powder that may cause direct damage when injected into a blood vessel, possibly eliciting vascular spasm and subsequent occlusion by the large [frontiersin.org]

Sickle cell disease – pathophysiology and treatment. Curr Probl Pediatr Adolesc Health Care. 2006;36:346–376. [PubMed] [Google Scholar] 30. Halasa NB, Shankar SM, Talbot TR, et al. [ncbi.nlm.nih.gov]

CONCLUSION: A single 1.0-g dose of azithromycin seems to be efficacious for prevention of syphilis in persons exposed to infected sexual partners. [ncbi.nlm.nih.gov]

(via heterocyclic antibiotic ) antibacterial drug A drug used to treat or prevent bacterial infections. drug allergen Any drug which causes the onset of an allergic reaction. [ebi.ac.uk]