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Benzathine penicillin G for the management of RHD: Concerns about quality and access, and opportunities for intervention and improvement

Benzathine penicillin G is an important antibiotic for the treatment and prevention of group A streptococcal infections associated with rheumatic fever and...

Authors:
Wyber R, Taubert K, Marko S, Kaplan EL

Authors notes:
Global Heart. 2013;8(3):227-234

Keywords:
Rheumatic fever, rheumatic heart disease, Benzathine penicillin G, group A streptococci, intervention

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.