Broderick Michael P, Hansen Christian J, Faix Dennis J
Henry M. Jackson Foundation at The Operational Infectious Diseases Department, Naval Health Research Center, San Diego, CA 92106, USA.
Pediatr Infect Dis J. 2012 Jul;31(7):722-5. doi: 10.1097/INF.0b013e31825051d4.
An interval of 3-4 weeks between intramuscular injections of 1.2 million units of benzathine penicillin G as prophylaxis against group A streptococcal infection is recommended by health organizations for patients with pediatric rheumatic fever and heart disease.
We reviewed the literature for evidence of the persistence of serum penicillin G during the first 4 weeks after the recommended dose of benzathine penicillin G.
The weighted-mean concentration was <0.02 µg/mL by 3 weeks after the initial dose. Weighted means were lower in studies done after 1990 than before (P<0.01), in studies dealing with secondary versus primary prophylaxis (P<0.01) and in studies in children versus those in adults (P<0.02).
Recommendations for benzathine penicillin G prophylaxis may need reevaluation.
卫生组织建议，对于患有小儿风湿热和心脏病的患者，肌内注射120万单位苄星青霉素G以预防A组链球菌感染时，两次注射之间的间隔应为3至4周。
我们查阅了文献，以寻找在推荐剂量的苄星青霉素G注射后前4周内血清青霉素G持续存在的证据。
初始剂量后3周时，加权平均浓度<0.02µg/mL。1990年以后进行的研究中的加权平均值低于之前（P<0.01），在涉及二级预防与一级预防的研究中（P<0.01）以及在儿童与成人的研究中（P<0.02）也是如此。
苄星青霉素G预防的建议可能需要重新评估。
