MMWR Morb Mortal Wkly Rep. 1999 Sep 10;48(35):777-9.
In October 1998, the Maryland Department of Health and Mental Hygiene (MDH) was notified that a public sexually transmitted disease (STD) clinic in a county (county A) had used a nonrecommended preparation to treat syphilis patients during January-October 1998. The clinic had been inadequately treating syphilis patients or syphilis contacts with Bicillin C-R (a mixture of 1.2 million units [MU] benzathine penicillin G [BPG] and 1.2 MU procaine penicillin G), rather than with Bicillin L-A (2.4 MU BPG). Compared with short-acting procaine penicillin G, BPG has a longer half-life considered essential for effective syphilis treatment because it yields sustained spirochetecidal levels needed to treat the slowly reproducing agent of syphilis, Treponema pallidum. The inadvertent use of Bicillin C-R, which contains only half the recommended dose of BPG for syphilis, was recognized by a health-care provider at the STD clinic in a neighboring county (county B) approximately 1 month after county B had borrowed BPG from county A. This report summarizes the investigation of the use of Bicillin C-R to treat STD patients in county A and discusses the frequency of Bicillin C-R use in STD clinics nationwide. Findings of this investigation indicate that inadvertent Bicillin C-R use is more frequent than previously known and that preventive measures should be taken to minimize such use.
1998年10月，马里兰州卫生与精神卫生部门（MDH）接到通知，某县（A县）的一家公共性传播疾病（STD）诊所于1998年1月至10月期间使用了未被推荐的制剂来治疗梅毒患者。该诊所一直未充分使用苄星青霉素L-A（240万单位苄星青霉素G [BPG]），而是使用苄星青霉素C-R（120万单位苄星青霉素G [BPG]与120万单位普鲁卡因青霉素G的混合物）来治疗梅毒患者或梅毒接触者。与短效的普鲁卡因青霉素G相比，BPG的半衰期更长，这被认为是有效治疗梅毒所必需的，因为它能产生持续的杀螺旋体水平，以治疗梅毒的缓慢繁殖病原体苍白密螺旋体。在邻近县（B县）的STD诊所从A县借用BPG大约1个月后，B县的一名医护人员发现了无意中使用了仅含梅毒推荐剂量一半BPG的苄星青霉素C-R的情况。本报告总结了对A县使用苄星青霉素C-R治疗STD患者的调查，并讨论了全国STD诊所使用苄星青霉素C-R的频率。本次调查结果表明，无意中使用苄星青霉素C-R的情况比之前所知更为频繁，应采取预防措施以尽量减少此类使用。
