title: Preliminary consultation on preferred product characteristics of benzathine penicillin G for secondary prophylaxis of rheumatic fever.
abstract: Rheumatic fever is caused by an abnormal immune reaction to group A streptococcal infection. Secondary prophylaxis with antibiotics is recommended for people after their initial episode of rheumatic fever to prevent recurrent group A streptococcal infections, recurrences of rheumatic fever and progression to rheumatic heart disease. This secondary prophylaxis must be maintained for at least a decade after the last episode of rheumatic fever. Benzathine penicillin G is the first line antibiotic for secondary prophylaxis, delivered intramuscularly every 2 to 4 weeks. However, adherence to recommended secondary prophylaxis regimens is a global challenge. This paper outlines a consultation with global experts in rheumatic heart disease on the characteristics of benzathine penicillin G formulations which could be changed to improve adherence with secondary prophylaxis. Characteristics included dose interval, pain, administration mechanism, cold chain independence and cost. A sample target product profile for reformulated benzathine penicillin G is presented.
authors.affiliation: Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Western Australia, 6008, Australia. Rosemary.Wyber@telethonkids.org.au.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Wyber
authors.affiliation: Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University (Parkville Campus), Parkville, Australia.
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Boyd
authors.affiliation: Murdoch Childrens Research Institute, University of Melbourne, Parkville, Australia.
authors.forename: Samantha
authors.initials: S
authors.lastname: Colquhoun
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Australia.|Royal Darwin Hospital, Darwin, Australia.
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Currie
authors.affiliation: Department of Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Mark
authors.initials: M
authors.lastname: Engel
authors.affiliation: College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
authors.forename: Joseph
authors.initials: J
authors.lastname: Kado
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ganesan
authors.initials: G
authors.lastname: Karthikeyan
authors.affiliation: Medicines Development for Global Health, Melbourne, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Sullivan
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Anita
authors.initials: A
authors.lastname: Saxena
authors.affiliation: Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Western Australia, 6008, Australia.
authors.forename: Meru
authors.initials: M
authors.lastname: Sheel
authors.affiliation: Group A Streptococcal Research Group, Murdoch Children's Research, University of Melbourne, Melbourne, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Steer
authors.affiliation: Department of Paediatrics, King Faisal Hospital, Kigali, Rwanda.
authors.forename: Joseph
authors.initials: J
authors.lastname: Mucumbitsi
authors.affiliation: Department of Paediatric Cardiology, University of Cape Town, Cape Town, South Africa.
authors.forename: Liesl
authors.initials: L
authors.lastname: Zühlke
authors.affiliation: Telethon Kids Institute, University of Western Australia, 100 Roberts Road, Subiaco, Western Australia, 6008, Australia.|Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Carapetis
mesh_terms: D001291:Attitude of Health Personnel; D004339:Drug Compounding; D016503:Drug Delivery Systems; D006801:Humans; D010401:Penicillin G Benzathine / Q000008:administration & dosage* / Q000627:therapeutic use*; D012213:Rheumatic Fever / Q000517:prevention & control*; D055502:Secondary Prevention / Q000379:methods*
chemical_list: D010401:Penicillin G Benzathine
keywords: Benzathine; Fever; Heart; Penicillin; Prophylaxis; Rheumatic