title: Benzathine Penicillin G for the Management of RHD: Concerns About Quality and Access, and Opportunities for Intervention and Improvement.
abstract: Benzathine penicillin G is an important antibiotic for the treatment and prevention of group A streptococcal infections associated with rheumatic fever and rheumatic heart disease. However, as rheumatic heart disease has receded as a public health priority in most high-income settings, attention to the supply, manufacture, and accessibility of benzathine penicillin G has declined. Concerns about the quality, efficacy, and innovation of the drug have emerged following plasma analysis and anecdotal reports from low-resource settings. This review collates core issues in supply and delivery of benzathine penicillin G as a foundation for concerted efforts to improve global quality and access. Opportunities for intervention and improvement are explored.
authors.affiliation: Telethon Institute for Child Health Research, Perth, Western Australia, Australia.. Electronic address: rwyber@ichr.uwa.edu.au.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Wyber
authors.affiliation: World Heart Federation, Geneva, Switzerland.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Taubert
authors.affiliation: University of Connecticut School of Medicine, Farmington, CT, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Marko
authors.affiliation: University of Minnesota Medical School, Minneapolis, MN, USA.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Kaplan