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Subcutaneous Infusion of Benzathine Penicillin G Is Acceptable and Preferred Over Intramuscular Injections for Syphilis in Western Australian Sexual Health Clinic Attendees

Controlling the syphilis epidemic in Australia is a public health priority. Regular intramuscular (IM) injections of benzathine penicillin G (BPG) are the current standard of care for late latent syphilis in Australia; however, repeated IM BPG injections are painful, and treatment completion rates are low. Early-phase clinical trials have demonstrated the tolerability and safety of high-dose subcutaneous infusions of BPG (SCIP), where the total treatment dose can be delivered at a single visit. Here we describe the experiences and preferences of attendees of Western Australian sexual health clinics in the Perth metropolitan region who have syphilis and were treated with SCIP.

Determinants of secondary prophylaxis for childhood rheumatic heart disease in Ethiopia: A qualitative study of children and caregivers

Rheumatic heart disease remains a major public health challenge in Ethiopia, particularly among children. Monthly intramuscular benzathine penicillin G is the cornerstone of secondary prophylaxis, yet adherence and delivery are suboptimal. This study explores the lived experiences of children and adolescents with RHD, capturing their direct voices and those of their caregivers to understand determinants of secondary prophylaxis uptake.

Increased burden of invasive group A streptococcal disease among Australian children, 2023–2024: a prospective cohort study

Global rates of invasive Group A Streptococcus (iGAS) disease surged from September 2022, exceeding pre-COVID-19 pandemic levels, showing atypical seasonality and disproportionately affecting children. We previously described the epidemiology of iGAS among Australian children from mid-2018 to end 2022 using data from the Paediatric Active Enhanced Diseases network and here provide updated clinical epidemiology for 2023 and 2024 to help inform public health strategies.

Pharmacokinetics of a three-dose regimen of intramuscular benzathine penicillin G in pregnant women with syphilis

Syphilis remains a global public health concern, particularly in pregnancy due to the risk of congenital syphilis. The WHO recommends benzathine penicillin G (BPG) as the standard treatment in pregnant women, whilst the optimal dosing strategy has not been established, particularly in relation to the impact of gestational age. This study sought to characterize the pharmacokinetics (PK) of a three-dose regimen of intramuscular BPG, given at weekly intervals, in pregnant women with syphilis.

Ingredients to Mask the Aversive Taste of Medicines: Lessons from the Pharmaceutical and Food Industries and Home Remedies Adopted by Caregivers

Many approved oral paediatric medicines continue to have poor taste acceptance, suggesting that the ingredient blends employed in these medicines are not adequately effective in taste-masking drugs with strongly aversive tastes. To address this inadequacy, this narrative review provides a comparative evaluation of taste-masking ingredients used by the pharmaceutical industry with those employed in the food industry, as well as food items used by caregivers to mask the unpalatable taste of medicines for young children.

Piperaquine Pharmacokinetic and Pharmacodynamic Profiles in Healthy Volunteers of Papua New Guinea after Administration of Three-Monthly Doses of Dihydroartemisinin-Piperaquine

Mass drug administration (MDA) with monthly dihydroartemisinin-piperaquine (DHA-PQP) appears useful in malaria control and elimination strategies. Determining the relationship between consecutive piperaquine phosphate (PQP) exposure and its impact on QT interval prolongation is a key safety consideration for MDA campaigns.

Standardization of Epidemiological Surveillance of Acute Rheumatic Fever

Acute rheumatic fever (ARF) is a multiorgan inflammatory disorder that results from the body's autoimmune response to pharyngitis or a skin infection caused by Streptococcus pyogenes (Strep A). Acute rheumatic fever mainly affects those in low- and middle-income nations, as well as in indigenous populations in wealthy nations, where initial Strep A infections may go undetected.

Study protocol for controlled human infection for penicillin G against Streptococcus pyogenes: a double-blinded, placebo-controlled, randomised trial to determine the minimum concentration required to prevent experimental pharyngitis (the CHIPS trial)

Regular intramuscular benzathine penicillin G injections have been the cornerstone of rheumatic heart disease (RHD) secondary prophylaxis since the 1950s. As the pharmacological correlate of protection remains unknown, it is difficult to recommend changes to this established regimen. Determining the minimum effective penicillin exposure required to prevent Streptococcus pyogenes infection will accelerate development of new long-acting penicillins for RHD prevention as well as inform opportunities to improve existing regimens. The CHIPS trial will address this knowledge gap by directly testing protection afforded by different steady state plasma concentrations of penicillin in an established model of experimental human S. pyogenes pharyngitis.

Standardization of epidemiological surveillance of rheumatic heart disease

Rheumatic heart disease (RHD) is a long-term sequela of acute rheumatic fever (ARF), which classically begins after an untreated or undertreated infection caused by Streptococcus pyogenes (Strep A). RHD develops after the heart valves are permanently damaged due to ARF.